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骨水泥棒外固定支架治疗第五掌骨颈骨折的有限元分析
Finite element analysis of cemented rod external fixation braces for the treatment of fifth metacarpal neck fractures
投稿时间:2023-07-03  
DOI:10.3969/j.issn.1672-5972.2024.02.001
中文关键词:  第五掌骨颈骨折  骨水泥棒外固定支架术  稳定性  交叉克氏针固定
英文关键词:Fifth metacarpal neck fracture  Cemented rod external fixation brace  Stability  Crossed Kirschner wire fixation
基金项目:贵阳市科技计划项目(筑科合同[2019]9-11-1号)
作者单位邮编
任远洋 贵州中医药大学骨伤学院贵州 贵阳550002 550002
季亮* 贵阳第四人民医院手足显微外科贵州 贵阳550002 550002
胡兴峰 贵阳第四人民医院手足显微外科贵州 贵阳550002 550002
李青松 贵阳第四人民医院手足显微外科贵州 贵阳550002 550002
梁伟 贵阳第四人民医院手足显微外科贵州 贵阳550002 550002
王洋 贵阳第四人民医院手足显微外科贵州 贵阳550002 550002
张博伟 贵阳第四人民医院手足显微外科贵州 贵阳550002 550002
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中文摘要:
      目的 采用三维有限元数值模拟方法分析比较骨水泥棒外固定支架与交叉克氏针在力学稳定性方面的差异,为手术治疗第五掌骨颈骨折(特别是第五掌骨颈开放性骨折)提供理论依据。方法 选取1名健康志愿者,采集其手腕关节的三维CT图像数据,首先利用Mimics Research 21.0、Geomagic Studio 2021软件进行三维图形数据处理,在此基础上应用Solidworks 2020软件构建第五掌骨颈骨折骨水泥棒外固定支架模型(A模型)和第五掌骨颈骨折交叉克氏针固定模型(B模型)。在ANSYS Workbench 17.0中对各模型的材料属性进行赋值、划分网格,建立三维有限元模型。最后通过在第五掌骨头远端关节面进行轴向施加和第五掌骨三点弯曲实验,计算得出两种施压方式的远端骨折块的最大位移,以此评价骨水泥棒外固定支架治疗第五掌骨颈骨折的稳定性。结果 ①轴向施压时,A模型远端骨折块的最大位移、最小位移和平均位移的值大于B模型,A模型近端骨折块的最大位移、最小位移和平均位移的值小于B模型,A模型最大相对位移、最小相对位移和平均相对位移大于B模型。②在三点折弯给力时,A模型远端骨折块最大位移小于B模型,远端骨折块最小位移等于B模型,近端骨折块的最大位移和最小位移的均值大于B模型,A模型最大相对位移、最小相对位移和平均相对位移大于B模型。③与B模型相比较,A模型的总体应力、固定物应力均明显较小。结论 骨水泥棒外固定支架及克氏针交叉固定在治疗第五掌骨颈骨折方面,在轴向和纵向上的位移及总位移均未超过1 mm,差异较小;但骨水泥棒外固定支架在两种施力方式中与交叉克氏针相比应力更小,提示骨水泥棒外固定支架能提供可靠的力学稳定性。
英文摘要:
      Objective To analyze and compare the difference in mechanical stability between external fixation with bone cement rod and crossed Kirschner wires, and to provide a theoretical basis for surgical treatment of the fifth metacarpal neck fracture, a three-dimensional finite element numerical simulation was used.Methods 3D CT image data of the wrist joint of a healthy volunteer were selected. Firstly, Mimics Research 21.0 and Geomagic Studio 2021 software were used to process the 3D graphic data. On this basis, Solidworks 2020 software was applied to construct the external fixation scaffold of bone cement rod for fracture of the neck of the fifth metacarpal bone model (model A) and cross Kirschner wire fixation for fracture of the neck of the fifth metacarpal bone model (model B). Material attributes of each model were assigned and meshed in ANSYS Workbench 17.0 to establish a three-dimensional finite element model. Finally, axial application and three-point bending of the fifth metacarpal were performed on the articular surface of the fifth metacarpal head to calculate the maximum displacement of the distal fracture block of the two pressure methods, so as to evaluate the stability of the external fixation of the bone cement rod in the treatment of the fifth metacarpal neck fracture.Results ① When axial pressure was applied, the values of the maximum, minimum displacement and average displacement of the distal fracture fragment of model A were greater than those of model B, the values of the maximum, minimum displacement and average displacement of the proximal fracture fragment of model A were smaller than those of model B, and the maximum relative displacement, minimum relative displacement and average relative displacement of model A were greater than those of model B. ②In three-point bending force application, the maximum displacement of the distal fracture block of model A was less than that in model B, the minimum displacement of the distal fracture block was equal to that in model B, the mean values of the maximum and minimum displacements of the proximal fracture block were greater than those in model B, and the maximum relative displacement, the minimum relative displacement, and the mean relative displacement were greater in model A than in model B. ③Comparison of the overall stresses and the stresses in the two fixtures between model A and model B. The stresses in model A were significantly lower than those in model B.Conclusion The displacement and total position of the external fixation stent of the cement rod and the cross fixation of the Kirschner wire did not exceed 1 mm in the axial and longitudinal directions in the treatment of the fifth metacarpal neck fracture, and the difference was small. However, the external fixation bracket of the bone cement rod has less stress than that of the crossed Kirschner wire in the two force application methods, indicating that the external fixation bracket of the bone cement rod can provide reliable mechanical stability.
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