重建钢板前置和上置固定锁骨中段斜形骨折的有限元分析
Finite element analysis of midshaft, oblique clavicle, fractures fixed with reconstruction plates in anterior and posterior placement
目的 通过三维有限元法对重建钢板前置和上置固定锁骨中段斜行骨折的生物力学稳定性进行比较，为临床应用提供理论参考。 方法 建立锁骨中段斜行骨折分别予以重建钢板前置位固定和上置位固定的三维有限元模型，相同的加载和约束条件下模拟轴向压缩、顺时针扭转、逆时针扭转和三点弯曲4种工况，评价不同内固定的最大等效应力、骨折块的最大综合位移和骨折断端的最大等效应力。 结果 ⑴压缩工况下前置位和上置位各评价指标无差异；⑵在顺时针扭转和弯曲时，前置位内固定装置的最大应力明显大于上置位，但骨折块的最大综合位移和骨折断端的最大应力差别不大；⑶在逆时针扭转工况下，上置位固定的各个指标数值虽大于前置位，但基本接近。 结论 对于重建钢板固定锁骨中段斜行骨折，前置位固定比上置位更容易出现应力集中，提示上置位固定的生物力学稳定性优于前置位。
Objective To explore and compare the biomechanical properties of midshaft, oblique clavicle fractures fixed with reconstruction plates in anterior and posterior placement using finite element(FE) analysis, and therefore to provide theoretic reference for clinic application. Methods 3D FE model of the midshaft, oblique clavicle fractures fixed with reconstruction plates in anterior and posterior placement was developed. Each mode was tested in axial compression, bending, internal, and external torsion. The different position fixations were compared for von Mises distribution, and the von Mises distribution of the fracture surface contact pressure, maximum comprehensive displacement were also compared. Results The evaluation index data showed no difference between plate fixation in anterior and superior placement under compression loading; under the bending, internal, and external torsion loading, the maximum stress of the anterior plate placement was significantly greater than that of the superior plate placement, but the fracture fragments displacement and the maximum stress on the fracture fragments showed no difference. Conclusions For the midshaft, oblique clavicle fractures, reconstruction plates in anterior placement is more prone to stress concentration than places in superior placment, suggesting that the biomechanical stability of the plates in superior placement is superior to that in anterior placement.
Clavicle / Fractures / Finite element analysis / Reconstruction plates
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