踝关节融合术两种固定方式的三维有限元分析Finite element modeling of ankle arthrodesis with two fixation techniques
欧阳汉斌;熊军;项鹏;崔壮;陈丽光;余斌;
摘要(Abstract):
[目的]通过三维有限元方法对踝关节融合的两种固定方式进行对比评价,并对其固定生物力学机制进行初步分析,为其临床应用提供理论依据。[方法]以正常人体踝关节CT扫描断层数据为基础,建立踝关节三维模型,模拟进行3螺钉固定和腓骨支撑固定手术,对模型中立、背屈、内旋和外旋4种载荷进行加载,分别进行有限元求解。[结果]3螺钉固定与腓骨支撑固定在抗旋转载荷上无明显差别,而在对抗背屈载荷作用优于腓骨支撑固定;在融合加压效果方面,3螺钉固定优于腓骨支撑固定,而腓骨支撑固定在移除外侧支撑腓骨后,加压作用有所下降;与腓骨支撑固定相比,3螺钉固定后的胫骨应力峰值更高且分布更集中,术后发生应力性骨折风险较高。[结论]在正常骨质条件下,3螺钉固定的生物力学稳定性以及融合加压效果均优于腓骨支撑固定,临床上建议首选3螺钉固定;而腓骨支撑固定的安全性较高,更适用于骨质条件较差的患者。
关键词(KeyWords): 踝关节;螺钉;融合;有限元;腓骨;生物力学
基金项目(Foundation): 国家自然科学基金资助项目(编号:81071233)
作者(Author): 欧阳汉斌;熊军;项鹏;崔壮;陈丽光;余斌;
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参考文献(References):
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