摘要
目的分析塑形对接骨板弯曲强度以及不同锁钉分布情况对接骨板受力的影响,为临床上对接骨板进行塑形与选择不同的锁钉分布方式提供生物力学依据。方法根据YY/T 0342—2020标准对接骨板四点弯曲强度进行有限元仿真分析,并应用理论分析及有限元仿真方法对不同锁钉分布的假体模型进行受力分析。结果在30°折弯时,3.7 mm厚接骨板比2.7 mm厚接骨板的等效塑性应变高28%;3.7、2.7 mm厚接骨板的极限折弯角度分别为55°、67°。折痕对接骨板受力影响较小,未塑形结构四点弯曲强度为2.64 N·m,等效弯曲刚度为1.12 N·m^(2);带折痕四点弯曲强度为2.63 N·m,等效弯曲刚度为1.10 N·m^(2);正反折弯后接骨板四点弯曲强度由2.64 N·m降低至2.45 N·m,降低约7.72%,等效弯曲刚度由1.12 N·m^(2)降低至0.98 N·m^(2),降低了12%,影响较为明显。植入填塞螺钉后单孔接骨板四点弯曲强度改善较为明显,由2.64 N·m提升至3.15 N·m,提升约19.32%,等效弯曲刚度由1.12 N·m^(2)提升至1.14 N·m^(2),提升幅度为2.1%。骨折线两侧至少各留出两个锁定孔不植入锁钉比打满锁钉应力降低约50%。在未形成骨痂的情况下,术后16周下地行走,TC4材质应力达到852.7 MPa,出现屈服。结论在需要进行较大塑形的临床场景下,不适合厚度过大的接骨板,厚度大塑形后更易出现接骨板断裂问题,可指导临床基于塑形角度选择合适厚度接骨板,极端情况可选择植入填塞螺钉。建议临床固定锁钉时,避免打满螺钉的固定锁钉方式;骨折线两端各保留两个锁定孔不固定锁钉,生物力学效果最好。
Objective To analyze the influence of shaping on the bending strength of bone plates and the influence of different locking nail distributions on plate force to provide biomechanical references for shaping plates and selecting different locking nail distributions.Methods Finite element simulation analysis of the four-point bending strength of a plate was performed according to the YY/T 0342—2020 standard.Theoretical analysis and finite element simulation method were used to analyze the force on prosthesis models with different lock-nail distributions.Results At 30°bending,the 3.7 mm-thick plate had 28%higher equivalent plastic strain than the 2.7 mm-thick plate.The 3.7 and 2.7 mm-thick plates had ultimate bending angles of 55°and 67°,respectively.The crease had little impact on the plate stress.The four-point bending strength and equivalent bending stiffness of the unshapeed structure were 2.64 N·m and 1.12 N·m^(2),respectively.The four-point bending strength and equivalent bending stiffness with the crease were 2.63 N·m and 1.10 N·m^(2),respectively.After forward and backward bending,the four-point bending strength of the plate decreased from 2.64 to 2.45 N·m by approximately 7.72%,and the equivalent bending stiffness decreased from 1.12 to 0.98 N·m^(2) by approximately 12%.The impact was obvious.After implantation of tamponade screws,the four-point bending strength of the single-hole plate improved significantly from 2.64 to 3.15 N·m,by approximately 19.32%and the equivalent bending stiffness increased from 1.12 to 1.14 N·m^(2),by approximately 2.1%.At least two locking holes were reserved on both sides of the fracture line.Not inserting the locking screw reduced the stress by approximately 50%compared with the full insertion of the locking screw.During 15-week postoperative walking without bone callus formation,the material stress of TC4 reached 852.7 MPa and yielding occurred.Conclusions In a clinical scenario where larger shaping is required,it is not suitable for plates with larger thicknesses and plate fractures are more likely to occur after large-thickness shaping.This can guide the clinical selection of plates with appropriate thickness based on the shaping angle,and tamponade screws can be implanted in extreme cases.Fixing locking screws clinically is recommended;however,a method of fixing the locking screws with full screws is not recommended.The biomechanical effect is best when two locking holes at both ends of the fracture line are maintained without fixing the locking screws.
作者
周望
徐剑晴
何思渊
张述
王俊文
焦竞
米博斌
刘国辉
朱威威
何智圣
张柳云
刘梦星
ZHOU Wang;XU Jianqing;HE Siyuan;ZHANG Shu;WANG Junwen;JIAO Jing;MI Bobin;LIU Guohui;ZHU Weiwei;HE Zhisheng;ZHANG Liuyun;LIU Mengxing(Wuhan Mindray Technology Co.,Ltd.,Wuhan 430065,China;School of Biological Science&Medical Engineering,Southeast University,Nanjing 210096,China;Tianjin Medical Device Quality Supervision and Inspection Center,Tianjin 300384,China;Department of Orthopedics,Wuhan Fourth Hospital,Wuhan 430030,China;Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China;Shenzhen Mindray Bio-medical Electronics Co.,Ltd.,Shenzhen 518057,Guangdong,China)
出处
《医用生物力学》
CAS
CSCD
北大核心
2024年第4期644-650,共7页
Journal of Medical Biomechanics
基金
湖北省重点研发计划项目(2022BAD175)
武汉市重点研发计划项目(2023020402010591)。
关键词
塑形
接骨板
锁钉分布
四点弯曲强度
有限元分析
shaping
bone plate
locking nail distribution
four-point bending strength
finite element analysis
