桡骨远端骨折锁定钢板的拓扑优化及有限元分析Topology optimization and finite element analysis of locking plate for distal radius fractures
钟环;欧阳汉斌;魏波;陈海聪;黄文华;杨洋;张晓东;陈焱君;
摘要(Abstract):
[目的]对桡骨远端骨折锁定钢板进行刚度最大化设计,运用有限元方法对重设计的钢板进行生物力学评价。[方法]运用三维建模软件和有限元分析软件完成个体化钢板的原型设计并进行初始分析,基于计算结果进一步对优化原型进行拓扑优化设计;通过有限元分析计算和对比常规钢板、优化原型钢板和优化钢板的体积、不同工况下的内固定刚度以及应力分布情况。[结果]所获得的优化钢板在体积上与常规锁定钢板相当,在轴向压缩刚度和扭转刚度方面均优于常规钢板,而在两种工况条件下优化钢板的应力峰值均低于常规钢板,应力分布更为均匀。[结论]对于桡骨远端骨折的个体化治疗,锁定钢板的拓扑优化能够为骨折的内固定提供可靠的方案。
关键词(KeyWords): 桡骨骨折;锁定钢板;有限元;拓扑优化;生物力学
基金项目(Foundation): 国家重点研发计划项目(编号:2017YFC1103403);; 广东省科技计划项目(编号:2016B090917001;2016B090925001;2017B090912006)
作者(Author): 钟环;欧阳汉斌;魏波;陈海聪;黄文华;杨洋;张晓东;陈焱君;
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参考文献(References):
- [1] Rozental TD, Blazar PE. Functional outcome and complications after volar plating for dorsally displaced, unstable fractures of the distal radius[J]. J Hand Surg Am, 2006, 31(3):359-365.
- [2]霍力为,王广伟,庾伟中,等.同一机构1年1 875例桡骨远端骨折流行病学分布特征[J].中国组织工程研究, 2012, 16(30):5591-5595.
- [3] Musgrave DS, Idler RS. Volar fixation of dorsally displaced distal radius fractures using the 2.4-mm locking compression plates[J].J Hand Surg Am, 2005, 30(4):743-749.
- [4] Nagy L. Salvage of post-traumatic arthritis following distal radius fracture[J]. Hand Clin, 2005, 21(3):489-498.
- [5] Wright TW, Horodyski MB, Smith DW. Functional outcome of unstable distal radius fractures:ORIF with a volar fixed-angle tine plate versus external fixation[J]. J Hand SurgAm, 2005, 30(2):289-299.
- [6] Drobetz H, Bryant AL, Pokorny T, et al. Volar fixed-angle plating of distal radius extension fractures:influence of plate position on secondary loss of reduction-a biomechanic study in a cadaveric model[J]. J Hand Surg Am, 2006, 31(4):615. e1-615. e9.
- [7]苗军,王继芳,夏群,等.磷酸钙水泥填充固定桡骨远端骨折的抗旋转生物力学研究[J].中华创伤骨科杂志, 2007, 9(3):251-254.
- [8]劳永锵,王明爽,梁伟春,等.桡骨远端骨折内固定术后两种康复锻炼方法比较[J].中国矫形外科杂志, 2016, 24(10):894-897.
- [9]刘兆杰,胡永成. DVR解剖型锁定钢板治疗陈旧性桡骨远端骨折的评价[J].中国矫形外科杂志, 2017, 25(22):2017-2021.
- [10] Cong A, Den Buijs JO, Dragomir-Daescu D. In situ parameter identification of optimal density-elastic modulus relationships in subject-specific finite element models of the proximal femur[J].Med Eng Phys, 2011, 33(2):164-173.
- [11]张国栋,陶圣祥,毛文玉,等.基于三维重建技术及有限元分析的骨密度测量[J].中国组织工程研究与临床康复, 2010, 14(9):1539-1544.
- [12]欧阳汉斌,谢普生,邓羽平,等.基于CT灰度赋值的有限元模型建立及其在截骨矫形中的应用[J].南方医科大学学报,2016, 36(7):979-983.
- [13] Drobetz H, Weninger P, Grant C, et al. More is not necessarily better. A biomechanical study on distal screw numbers in volar locking distal radius plates[J]. Injury, 2013, 44(4):535-539.
- [14] Wall LB, Brodt MD, Silva MJ, et al. The effects of screw length on stability of simulated osteoporotic distal radius fractures fixed with volar locking plates[J]. J Hand Surg Am, 2012, 37(3):446-453.
- [15]董强,马信龙,马宝通,等. LCP钢板与外固定架治疗C型桡骨远端骨折的疗效比较[J].中华骨科杂志, 2012, 32(3):249-253.
- [16]钱光,吴俊国,董有海,等.掌侧锁定接骨板结合背侧支撑钢板固定治疗不稳定的背侧移位桡骨远端骨折[J].中国矫形外科杂志, 2016, 24(24):2291-2293.
- [17]姜保国.桡骨远端骨折术后临床随访及功能恢复不良的分析[J].中华手外科杂志, 2008, 24(2):66-68.
- [18] Leung F, Zhu L, Ho H, et al. Palmar plate fixation of AO type C2fracture of distal radius using a locking compression plate-a biomechanical study in a cadaveric model[J]. J Hand Surg Br, 2003, 28(3):263-266.
- [19] Osada D, Viegas SF, Shah MA, et al. Comparison of different distal radius dorsal and volar fracture fixation plates:a biomechanical study[J]. J Hand Surg Am, 2003, 28(1):94-104.
- [20] Mehling I, Müller LP, Delinsky K, et al. Number and locations of screw fixation for volar fixed-angle plating of distal radius fractures:biomechanical study[J]. J Hand Surg Am, 2010, 35(6):885-891.
- [21]廖智奇,吴运新,袁海洋,等.表面粗糙度对三维应力集中系数及疲劳寿命的影响[J].中国机械工程, 2015, 26(2):147-151.
- [22]王宏川,马宝通,马剑雄,等.股骨远端LISS倒置固定股骨转子下骨折的生物力学研究[J].中国矫形外科杂志, 2015, 23(8):733-737.
- [23] Schileo E, Taddei F, Malandrino A, et al. Subject-specific finite element models can accurately predict strain levels in long bones[J]. J Biomech, 2007, 40(13):2982-2989.