首页|Schanz钉不同置入方式与骨盆髂嵴外固定架力学稳定性的有限元分析

Schanz钉不同置入方式与骨盆髂嵴外固定架力学稳定性的有限元分析

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目的 利用有限元分析骨盆髂嵴外固定架中两种Schanz钉置钉深度对于骨盆髂嵴外固定架的生物力学差异.方法 取1名男性成年志愿者,44岁,身高170 cm,体重75 kg.应用螺旋CT薄层连续扫描髂棘至坐骨支,在CT数据基础上,通过三维建模软件建立骨盆数字模型.模拟Schanz钉Shallow和Deep两种不同置入方式,分别建立两组分析方案(同一参数体现).其中Shallow方案为骨盆髂嵴打入Schanz钉为50 mm,满足螺纹全部进入骨质;Deep方案为沿同一方向将髂嵴Schanz钉打入直至臼顶后方相对致密的骨质内(距髋臼顶部10 mm).利用有限元分析对两组模型的骶髂关节及耻骨联合处施加以同样约束载荷,在距骨盆髂嵴外部边界50 mm Schanz钉处给予两组模型同种载荷,计算应力分布与形变.结果 两组模型在同一种载荷下,Shallow方案最大应力发生在骨盆髂嵴松质骨部分,应力峰值为87.151 MPa,Schanz钉最大位移为0.67139 mm,Deep方案最大应力发生在骨盆髂嵴皮质骨部分,应力峰值为59.183 MPa,Schanz钉最大位移为0.41773 mm.Deep方案应力峰值较Shallow方案减少32.1%,Schanz钉最大位移减少37.8%.结论 Shallow和Deep两种置钉方案中,Deep方案生物力学稳定性更强,位移形变更小,Schanz钉上的应力分布更均匀,稳定性可提高47%.深入置钉的方法能更有效的预防Schanz钉松动、失效,是在骨盆骨折外固定架治疗中值得推广的置钉方式.
Finite element analysis on biomechanical stability of different depths of Schanz nail in pelvic iliac crest external fixator
Objective To compare the biomechanical stability of Schanz nailing at different depths for pel-vic iliac crest external fixator by finite element(FE)analysis.Methods An adult male volunteer of 44 years old,170 cm in height and 75 kg in weight,was selected.Spiral CT was used to scan the iliac spine to the ischial branch continuously.Based on the CT data,a digital model of the pelvis was established by 3D modeling software.Two dif-ferent implantation depths of the Schanz nail were simulated,i.e.Shallow and Deep.In the Shallow scheme,the Schanz nail was inserted into the pelvic iliac crest by 50 mm,which ensured that all the threads entered the bone;while in the Deep scheme,the iliac crest Schanz nail was inserted into the relatively dense bone(10 mm from the top of the acetabulum)in the same direction.An equal constraint load was applied to the sacroiliac joint and the pu-bic symphysis of the two groups of models by FE analysis,and the same load was given to the Schanz nail 50 mm from the outer boundary of the pelvic iliac crest.Then the stress distribution and deformation were calculated.Re-sults In the two groups of models,under the same load,the maximum stress of the Shallow scheme occurred in the cancellous bone of the pelvic iliac crest,and the maximum stress was 87.151 MPa with the maximum displacement of the Shallow Schanz nail being 0.67139 mm.The maximum stress of the Deep scheme occurred in the pelvic iliac crest cortical bone,and the peak stress was 59.183 MPa,with the maximum displacement of the Deep Schanz nail being 0.41773 mm.Compared with the Shallow scheme,the peak stress of the Deep scheme was reduced by 32.1%and the maximum displacement of the Schanz nail was reduced by 37.8%.Conclusion Between the two Schanz nail placement schemes of Shallow and Deep,the biomechanical stability of the Deep scheme is stronger,the change of displacement is smaller,the stress distribution on the Schanz nail is more uniform,and the stability can be im-proved by 47%.In-depth nail placement can more effectively prevent Schanz nail loosening and failure,which is worth popularizing in the treatment of pelvic fractures with external fixators.

PelvicSchanz nailNailing methodFinite element analysis

赵德来、李洪涛、侯飙、戴鸿哲、冯晶辉、聂广辰

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哈尔滨市第五医院骨科,哈尔滨 150040

黑龙江中医药大学附属第一医院骨伤一科,哈尔滨 150040

黑龙江省气象数据中心,哈尔滨 150030

哈尔滨工业大学土木工程学院,哈尔滨 150090

哈尔滨学院,哈尔滨 150076

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骨盆 Schanz钉 置钉方式 有限元分析

黑龙江省医药卫生科研课题基金项目

20220404070715

2024

创伤外科杂志
第三军医大学,大坪医院,野战外科研究所

创伤外科杂志

CSTPCD
影响因子:1.017
ISSN:1009-4237
年,卷(期):2024.26(10)