CAJ | 학술논문

目的对髂骨翼(IW)与髋臼上方(SA)2种置钉技术在Tile-B1型骨盆骨折固定的生物力学机理进行有限元分析,为临床治疗提供参考.方法构建包含韧带结构的骨盆三维有限元模型,模仿Tile B1型骨盆骨折工况.在Abaqus有限元软件中进行模拟加载,比较SA外固定支架、IW外固定支架及耻骨联合钢板固定等工况的生物力学特点.结果位移分析提示耻骨联合部位坚强的固定有利于控制水平方向的位移.Mises应力云图显示IW外固定支架主要通过直接将健侧应力传导至患侧髂骨翼;而SA外固定支架一方面将健侧应力直接传导至患侧髋臼上方,另一方面也增加了骶髂关节的应力传导.由于髋臼上骨质厚实,置入较粗固定钉的安全性较好.结论 SA外固定支架技术可有效恢复骨盆前方稳定性,且有利于后方骶髂关节稳定性的重建,生物力学性能总体优于传统IW外固定支架技术,是Tile B1型骨盆骨折的良好固定方式.
목적 대가골익(IW)여관구상방(SA)2충치정기술재Tile-B1형골분골절고정적생물역학궤리진행유한원분석,위림상치료제공삼고.방법 구건포함인대결구적골분삼유유한원모형,모방Tile B1형골분골절공황.재Abaqus유한원연건중진행모의가재,비교SA외고정지가、IW외고정지가급치골연합강판고정등공황적생물역학특점.결과 위이분석제시치골연합부위견강적고정유리우공제수평방향적위이.Mises응력운도현시IW외고정지가주요통과직접장건측응력전도지환측가골익;이SA외고정지가일방면장건측응력직접전도지환측관구상방,령일방면야증가료저가관절적응력전도.유우관구상골질후실,치입교조고정정적안전성교호.결론 SA외고정지가기술가유효회복골분전방은정성,차유리우후방저가관절은정성적중건,생물역학성능총체우우전통IW외고정지가기술,시Tile B1형골분골절적량호고정방식.
Objective To compare iliac wing (IW) and supra-acetabular (SA) external fixations for treatment of Tile Bl pelvic fracture through a finite element biomechanical analysis. Methods A three-dimensional finite element model of the pelvis including the ligament structure was constructed. Conditions of Tile B1 pelvic fracture were simulated in the model. In the Abaqus finite element software, simulated loads were applied to compare biomechanical parameters of SA, IW, and pubic symphysis (PS) fixations.Results Displacement analysis indicated that strong PS fixation benefited control of the horizontal displacement. Mises stress contour showed that the IW bracket directly transmitted the stress from the unaffected side to the affected side to restore the stability of the sacroiliac joint. The SA bracket not only directly transmitted the stress from the unaffected side to the superior part of the affected side, but also increased the stress transmission throughout the sacroiliac joint. On the thick SA bone, strong nails could be used for better fixation. Conclusions SA external fixation can effectively restore the anterior stability of the pelvis, and benefits reconstruction of the posterior stability of the sacroiliac joint. Since overall biomechanical properties of SA external fixation are superior to those of the traditional IW bracket, SA fixation is better than IW one for Tile Bl pelvic fractures.