摘要
目的利用有限元法分析踝天节下胫腓联合损伤两种位置螺钉固定对踝关节应力分加的影响方法选取1名30岁男性健康志愿者的右足螺旋CT扫描图像，利用Mimics10．01、Solid—Works2009等软件进行骨骼的三维重建、模拟韧带连接和生成关节接触等．分别建立包含正常踝关节、下胫腓联合拟伤踝上2．5cm、5．0cm螺钉固定的三维有限冗模型．在模型中设置相应的边界条件分别模拟踝关节在中立位站立、内旋、外旋时所受外力，进行加载计算。结果 获得了踝关节在5种加载中各组织的Von Mises应力分布。相对于正常踝关节，踝上2．5cm、5．0cm螺钉固定后均导致踝周韧带的应力降低、承受载荷时减少，而小腿骨间腆应力增高，其中在踝关节内旋时近端小腿骨间膜腓骨附着点应力分别达28．91和27．76MPa；各主要天竹的接触力也降低，其中在模拟踝父协内旋时胫距关协接触力分别为136．55N和120．14N，腓距火节的接触力分别为42．68N和39．33N，而馍拟踝关节外旋时胫距关节接触力分别为167．93N和158．17N，腓距关节的接触力分别为39．47N和40．21N。结论两种化哉的螺钉固定后均可致踝关节应力分布发生改变，但两者差异不明显。
Objective To analyze the effects of 2 different screw positions on the stress distribution at the ankle in three-dimensional finite element models of screw fixation of the inferior tibiofibular svndesmo- sis. Methods Helical CT scan images of the right foot of a 30 yearloht male volunteer were obtained. So[＇tware （Mimics, SolidWorks and Simulation） was used to reconstruct three-dimensional bone structures, to simulate ligamentous connections and tn generate articular contacts in 3 finite clement models of normal ankle, screw fixation for tibiofibular syndesmosis injury with screw placement at 2.5 cm and 5.0 cm above the tibiotalar joint respectively. Loads were applied in simulations of the ankle at the neutral position with single-foot standing. intm＇nal rotation and external rotation h^r calculation of the stress distributions at the ankle. Results Screw fixalion with 2 different placement positions decreased the stresses on the periarticular ligaments o[＂ Ihe ankle but increased the stresses on the cmral interosseous membrane. The stresses on the fibular attachment point of the proximal crural interosseons membrane increased to 28.91 MPa and 27.76 MPa respectively in the load simulation under internal l＇otation of the ankle. The contact threes at the major articulations were reduced. The contact forces in the load simulation under internal rotation of the ankle decreased to 136.55 N and 120. 14 N between the tibia and talus, and 42.68 N and 39.33 N between the fibula and talus; the contact forces in the load simulation under external rotation of the ankle decreased to 167.93 N and 158. 17 N between the tibia and talus, and 39.47 N and 40.21 N between the fibula and talus, respectively. Conclusion The three-dimensional finite element models of screw fixation of the interior tibiofibular syndesmosis show that 2 diftkrent screw placement positions will lead to changes in the stress distribution at the ankle but the differ- ences are m）t significant between the 2 positions.
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2013年第9期778-783,共6页
Chinese Journal of Orthopaedic Trauma
基金
国家自然科学鉴金（81071233）
陕西省社会发展攻关项目（2011K12-05-13）
关键词
内固定
生物力学
有限元分析
下胫腓联合损伤
Internal fixation
Biomechanics
Finite element analysis
Interior tibiofibular syndesmosis injury
