中华骨科杂志
中華骨科雜誌
중화골과잡지
CHINESE JOURNAL OF ORTHOPAEDICS
2013年
4期
336-341
,共6页
黄海晶%马信龙%马剑雄%金鸿宾
黃海晶%馬信龍%馬劍雄%金鴻賓
황해정%마신룡%마검웅%금홍빈
有限元分析%跟骨%骨折愈合%应力,物理
有限元分析%跟骨%骨摺愈閤%應力,物理
유한원분석%근골%골절유합%응력,물리
Finite element analysis%Calcaneus%Fracture healing%Stress,mechanical
目的 探讨在静力载荷作用下,正常与畸形愈合跟骨的应力分布差异.方法 将正常跟骨有限元模型的后关节面由内向外、由前向后楔形切除,模拟骨折后距下关节面塌陷的畸形愈合模型.切除前B(o)hler角为35°,切除后为0°.自足跟及跟腱附着点处分别垂直向上对模型施加320 N和160 N的载荷,观察畸形愈合跟骨的Vonmises应力分布,并与正常模型进行比较.结果 畸形愈合跟骨的距下关节面应力降低,应力分布特点为从正常的跟骨前中关节面为主要应力区转为跟骨外侧紧靠跟骰关节处,外侧主要应力区要高于内侧,是支撑载荷的主要部位.从跟骨结构的细化比较来看,首先,距下关节面顶部的塌陷造成跟骨主要应力区部分后移,转至跟腱附着点处由正常的(1.51 ±0.22) MPa增至(3.11±0.24) MPa,而距下关节面顶部的应力由正常的(6.71±0.37) MPa减至(2.83±0.49) MPa.其次,跟骨前侧近跟骰关节处应力明显加大,由正常的(0.46±0.15) MPa增至(2.13±0.15) MPa,载距突应力由5.18 MPa减少至1.41MPa.结论 跟骨骨折距下关节面塌陷是多数病理变化的主因,在临床治疗中应先解决距下关节面的塌陷问题,恢复跟骨正常高度,跟骨内部应力的分布对解决跟骨骨折后期出现的相关部位疼痛至关重要.
目的 探討在靜力載荷作用下,正常與畸形愈閤跟骨的應力分佈差異.方法 將正常跟骨有限元模型的後關節麵由內嚮外、由前嚮後楔形切除,模擬骨摺後距下關節麵塌陷的畸形愈閤模型.切除前B(o)hler角為35°,切除後為0°.自足跟及跟腱附著點處分彆垂直嚮上對模型施加320 N和160 N的載荷,觀察畸形愈閤跟骨的Vonmises應力分佈,併與正常模型進行比較.結果 畸形愈閤跟骨的距下關節麵應力降低,應力分佈特點為從正常的跟骨前中關節麵為主要應力區轉為跟骨外側緊靠跟骰關節處,外側主要應力區要高于內側,是支撐載荷的主要部位.從跟骨結構的細化比較來看,首先,距下關節麵頂部的塌陷造成跟骨主要應力區部分後移,轉至跟腱附著點處由正常的(1.51 ±0.22) MPa增至(3.11±0.24) MPa,而距下關節麵頂部的應力由正常的(6.71±0.37) MPa減至(2.83±0.49) MPa.其次,跟骨前側近跟骰關節處應力明顯加大,由正常的(0.46±0.15) MPa增至(2.13±0.15) MPa,載距突應力由5.18 MPa減少至1.41MPa.結論 跟骨骨摺距下關節麵塌陷是多數病理變化的主因,在臨床治療中應先解決距下關節麵的塌陷問題,恢複跟骨正常高度,跟骨內部應力的分佈對解決跟骨骨摺後期齣現的相關部位疼痛至關重要.
목적 탐토재정력재하작용하,정상여기형유합근골적응력분포차이.방법 장정상근골유한원모형적후관절면유내향외、유전향후설형절제,모의골절후거하관절면탑함적기형유합모형.절제전B(o)hler각위35°,절제후위0°.자족근급근건부착점처분별수직향상대모형시가320 N화160 N적재하,관찰기형유합근골적Vonmises응력분포,병여정상모형진행비교.결과 기형유합근골적거하관절면응력강저,응력분포특점위종정상적근골전중관절면위주요응력구전위근골외측긴고근투관절처,외측주요응력구요고우내측,시지탱재하적주요부위.종근골결구적세화비교래간,수선,거하관절면정부적탑함조성근골주요응력구부분후이,전지근건부착점처유정상적(1.51 ±0.22) MPa증지(3.11±0.24) MPa,이거하관절면정부적응력유정상적(6.71±0.37) MPa감지(2.83±0.49) MPa.기차,근골전측근근투관절처응력명현가대,유정상적(0.46±0.15) MPa증지(2.13±0.15) MPa,재거돌응력유5.18 MPa감소지1.41MPa.결론 근골골절거하관절면탑함시다수병리변화적주인,재림상치료중응선해결거하관절면적탑함문제,회복근골정상고도,근골내부응력적분포대해결근골골절후기출현적상관부위동통지관중요.
Objective To compare the stress distribution of calcaneal compression articular surface and normal surface in biomechanical analysis.Methods The posterior articular facet of the normal finite element model was wedged resected from inside to outside and from front to back,to imitate the malunion model with subtalar articular surface collapse after fracture.The B(o)hler angle was 35° before wedged,and 0° after wedged.On heel and Achilles tendon attachment point,320 N and 160 N loads were applied vertically upwards respectively.Compare calcaneal Vonmises stress distribution between malunion and normal model.Results Judging from the general stress distribution of malunion of calcaneal,subtalar joint stress reduced.The main stress area of normal bone joints was in articular surface,while the main stress area of malunion model was in the lateral calcaneal close to the calcaneocuboid joint.The main stress of the outboard is high-er than that of inboard.Outboard is the main part of supporting load.Judging from the detailed comparison with bone structure,first of all,the subsidence of subtalar joint top resulted in partial backward of the main stress of the calcaneus,which shifted to the Achilles tendon attachment point.It increased from normal (1.51±0.22) MPa to (3.11±0.24) MPa.Joint top of the stress reduced from normal (6.71±0.37) MPa to (2.83± 0.49) MPa.Secondly,the calcaneus stress of the former calcaneocuboid articulation significantly increased,which increased from normal (0.46±0.15) MPa to (2.13±0.15) MPa,and sustentaculum tali stress decreased from 5.18 MPa to 1.41 MPa.Conclusion By finite element model of this subject,the study proves that subtalar joint surface collapsed in calcaneal fractures is the main causes of most pathological changes.The problem of the joint surface subsidence should be resolved firstly in a clinical treatment,and the normal height of the calcaneus should be restored.The internal stress distribution of calcaneal is essential to the pain in the related part of calcaneal.
