CAJ | 학술논문

背景:髓内针为长骨转移癌预防性内固定的常用选择之一,但存在锁钉周围应力集中,锁钉弯曲或折断等问题.选择更为坚强、持久的预防性内固定可有效改善骨转移癌患者的生存质量.目的:研究适用于长骨转移癌的多孔髓内针的生物力学特性,为选取打孔方案及生物力学试验提供理论依据.方法:采用有限元分析的方法,测量4种长骨髓内针打孔方案下截面刚度及整体刚度的变化,孔直径有2 mm与3 mm两种,导程有11 mm与22 mm两种.结果:孔直径2 mm对截面拉压刚度及扭转刚度降低8.45%和8.13%,对平行于打孔平面方向的弯曲刚度几乎无影响,但在垂直于打孔平面方向的弯曲刚度降低15.96%.髓内针采取孔直径2 mm、导程11mm、每导程4个孔、孔均匀布置的打孔方案,载荷下应力增长率及整体刚度改变最小.结论:髓内针侧壁打孔可造成髓内针刚度降低,孔周围出现应力集中的现象,影响髓内针的抗疲劳性.综合静态压缩、弯曲的分析结果,孔直径2 mm,导程11 mm,每导程4个孔,孔均匀布置的打孔方案的效果最佳.
배경:수내침위장골전이암예방성내고정적상용선택지일,단존재쇄정주위응력집중,쇄정만곡혹절단등문제.선택경위견강、지구적예방성내고정가유효개선골전이암환자적생존질량.목적:연구괄용우장골전이암적다공수내침적생물역학특성,위선취타공방안급생물역학시험제공이론의거.방법:채용유한원분석적방법,측량4충장골수내침타공방안하절면강도급정체강도적변화,공직경유2 mm여3 mm량충,도정유11 mm여22 mm량충.결과:공직경2 mm대절면랍압강도급뉴전강도강저8.45%화8.13%,대평행우타공평면방향적만곡강도궤호무영향,단재수직우타공평면방향적만곡강도강저15.96%.수내침채취공직경2 mm、도정11mm、매도정4개공、공균균포치적타공방안,재하하응력증장솔급정체강도개변최소.결론:수내침측벽타공가조성수내침강도강저,공주위출현응력집중적현상,영향수내침적항피로성.종합정태압축、만곡적분석결과,공직경2 mm,도정11 mm,매도정4개공,공균균포치적타공방안적효과최가.
@@@@Background:Intramedullary nail has been commonly used in preventive internal fixation for metastasis in long bones, but it is likely to be followed by problems like stress concentrating around the locking nail, bending or broken of the locking nail, etc. Selecting a stronger and more durable preventive internal fixation can effectively improve patients' quality of life. Objective:To investigate the biomechanical properties of the multihole intramedullary nail which is suitable for treating me-tastasis in long bones, and provide theoretical foundation for puncturing scheme selections and biomechanical experiments. Methods:Analyze the change of section rigidity and general rigidity of long-bone intramedullary nails under 4 different punc-turing schemes by finite element analysis. The hole diameter is either 2mm or 3mm, and the lead is either 22 mm or 11 mm. Results:With 2 mm diameter holes, the pull-pressing rigidity and torsional rigidity were decreased by 8.45%and 8.13%on the section, and the bending rigidity was decreased by up to 15.96%on the direction vertical to the punctured section. But the diameter of the holes has no impact on the bending rigidity on the direction parallel to the punctured section. The intra-medullary nail with a puncturing scheme of 2 mm diameter holes, 11 mm leads, and 4 uniformly distributed holes per lead can load the lower stress growth rate and minimize the general rigidity. Conclusions:Puncturing on the side walls of the intramedullary nails can decrease the rigidity of intramedullary nails and cause stress concentrating around the nails. It will affect the fatigue resistance of the intramedullary nails. According to the comprehensive analysis results of the static compression and bending of the intramedullary nails, the puncturing scheme of 2 mm diameter holes, 11 mm leads, and 4 uniformly distributed holes per lead can achieve the best curative effects.