本文關(guān)鍵詞：股骨骨折內(nèi)固定金屬接骨板的生物力學(xué)性能研究　出處：《西南交通大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 金屬接骨板 力學(xué)環(huán)境 數(shù)值模擬 骨折愈合

【摘要】：隨著生物學(xué)固定理念的不斷完善,鎖定加壓接骨板被廣泛應(yīng)用于骨折內(nèi)固定治療。與過(guò)分強(qiáng)調(diào)解剖復(fù)位的堅(jiān)強(qiáng)內(nèi)固定相比,生物學(xué)固定(彈性固定)允許骨折斷端存在一定程度的微動(dòng),并認(rèn)為微動(dòng)能促進(jìn)骨痂形成,進(jìn)而誘導(dǎo)骨折的間接愈合。間接愈合過(guò)程對(duì)骨折端的力學(xué)環(huán)境極為敏感,任何不適宜的應(yīng)力都可能導(dǎo)致骨折延遲愈合甚至不愈合等臨床并發(fā)癥。內(nèi)固定系統(tǒng)的穩(wěn)定性是影響骨折端力學(xué)環(huán)境的重要因素之一,而接骨板本身的設(shè)計(jì)參數(shù)和力學(xué)性能及接骨板在臨床手術(shù)中的固定方式等諸多因素對(duì)內(nèi)固定系統(tǒng)的穩(wěn)定性均有一定程度的影響。因此,有必要從骨折愈合的角度研究這些因素對(duì)內(nèi)固定系統(tǒng)的影響,研究結(jié)果可為臨床內(nèi)固定手術(shù)操作提供一定參考,也可為接骨板的優(yōu)化設(shè)計(jì)提供理論依據(jù)。本文通過(guò)建立股骨干中段橫形骨折內(nèi)固定系統(tǒng)的有限元模型,采用數(shù)值模擬方法,以骨折塊應(yīng)變理論為基礎(chǔ),模擬了骨折愈合早期的動(dòng)態(tài)愈合過(guò)程,考察了接骨板固定參數(shù)(植入螺釘數(shù)量、固定位置、螺釘預(yù)緊力等)、接骨板材料和長(zhǎng)度對(duì)骨折愈合過(guò)程的影響,分析了骨折間隙與接骨板材料和長(zhǎng)度的匹配關(guān)系。主要結(jié)果和結(jié)論總結(jié)如下:(1)接骨板的固定參數(shù)會(huì)顯著影響骨折的愈合過(guò)程。螺釘預(yù)緊力對(duì)骨折愈合中骨痂發(fā)育、股骨和接骨板上的應(yīng)力分布均無(wú)顯著影響,但股骨上螺釘孔處的最大應(yīng)力隨螺釘預(yù)緊力增大而增大;采用8孔鎖定加壓接骨板固定股骨干橫形骨折時(shí),骨折線兩側(cè)的骨折塊上應(yīng)植入的螺釘數(shù)量不能低于3枚;鄰近骨折線的兩枚螺釘對(duì)骨折愈合的影響最顯著,必須固定。(2)就固定效果而言,骨折間隙與金屬接骨板的彈性模量呈負(fù)相關(guān)。不銹鋼接骨板的最佳固定骨折間隙為1-2 mm,純鈦接骨板的最佳固定骨折間隙為2-3 mm,鎂合金接骨板的最佳固定骨折間隙為4-5 mm:相同材質(zhì)的金屬接骨板,當(dāng)骨折間隙較大時(shí),應(yīng)選擇板長(zhǎng)較長(zhǎng)的接骨板,更有利于為骨折愈合后期提供足夠的固定穩(wěn)定性。(3)不銹鋼、純鈦和鎂合金三種金屬接骨板在骨折愈合早期的應(yīng)力遮擋率均較高,無(wú)明顯差異,接骨板材料主要通過(guò)影響骨痂彈性模量而對(duì)應(yīng)力遮擋率產(chǎn)生影響。
[Abstract]:With the improvement of biological fixation concept, locking compression plate has been widely used in the treatment of fracture internal fixation, compared with the rigid internal fixation with too much emphasis on anatomical reduction. Biological fixation (elastic fixation) allows a certain degree of fretting at the fracture end and suggests that microkinetic energy promotes callus formation. The indirect healing process is very sensitive to the mechanical environment of the fracture end. Any inappropriate stress may lead to clinical complications such as delayed fracture healing or even nonunion. The stability of internal fixation system is one of the important factors that affect the mechanical environment of fracture end. However, the design parameters and mechanical properties of the plate itself, as well as the fixation mode of the plate in the clinical operation have a certain degree of influence on the stability of the internal fixation system. It is necessary to study the influence of these factors on the internal fixation system from the angle of fracture healing. It can also provide theoretical basis for the optimal design of the plate. In this paper, the finite element model of the internal fixation system of femoral shaft transverse fracture is established, and the method of numerical simulation is adopted, which is based on the strain theory of fracture block. The dynamic healing process in the early stage of fracture healing was simulated, and the effects of plate fixation parameters (number of screws, fixation position, screw pretension force, material and length of plate) on fracture healing were investigated. The matching relationship between the fracture gap and the material and length of the plate is analyzed. The main results and conclusions are summarized as follows: 1). The fixation parameters of the plate can significantly affect the healing process of the fracture. There was no significant effect on the stress distribution in the femur and the plate, but the maximum stress at the hole of the screw increased with the increase of the pretightening force of the screw. When the femoral shaft transverse fracture was fixed with 8-hole locking compression plate, the number of screws should not be less than 3 on both sides of the fracture line. The two screws adjacent to the fracture line have the most significant effect on fracture healing and must be fixed. The best fixation gap of stainless steel plate was 1-2 mm, and that of pure titanium plate was 2-3 mm. The best fixation gap of magnesium alloy plate is 4-5 mm. When the fracture gap is large, the long plate should be chosen. It is more favorable to provide enough fixation stability for fracture healing. Stainless steel, pure titanium and magnesium alloy metal plates have higher stress shielding rate in the early stage of fracture healing, but there is no significant difference. The plate material mainly affects the stress shielding rate by influencing the elastic modulus of callus.
【學(xué)位授予單位】：西南交通大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R687.3;R318.01

【參考文獻(xiàn)】

相關(guān)期刊論文 前9條

1 戴閩;于小龍;;骨折治療的思考-AO、BO的演變及CO時(shí)代的到來(lái)[J];中國(guó)骨與關(guān)節(jié)損傷雜志;2016年04期

2 譚柯;;骨折內(nèi)固定物發(fā)生斷裂的原因及臨床分析[J];中國(guó)衛(wèi)生產(chǎn)業(yè);2014年20期

3 董雙鵬;王成燾;齊寶芬;張述;焦永哲;張路;陳長(zhǎng)勝;;肱骨內(nèi)植物材料選擇及預(yù)緊力影響的參數(shù)化研究[J];中國(guó)骨與關(guān)節(jié)外科;2014年01期

4 林峰;姚天平;王成燾;丁彪;;肱骨外科頸接骨板斷裂有限元建模和應(yīng)力分析[J];中國(guó)醫(yī)療器械雜志;2013年02期

5 邢丹;馬信龍;宋東輝;馬劍雄;徐衛(wèi)國(guó);王杰;楊陽(yáng);陳陽(yáng);;長(zhǎng)骨骨折愈合力學(xué)環(huán)境的研究現(xiàn)狀[J];生物醫(yī)學(xué)工程與臨床;2012年06期

6 楊紅艷;傅增祥;黃杏利;馬彬銳;;骨折愈合中組織分化的力學(xué)調(diào)節(jié)模型[J];北京生物醫(yī)學(xué)工程;2007年04期

7 王正梅,樊曙先,謝學(xué)儉,高桂芝;骨折內(nèi)固定器材料的研究進(jìn)展[J];南通大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2005年03期

8 楊明輝,武勇;微動(dòng)與骨折愈合[J];國(guó)外醫(yī)學(xué).骨科學(xué)分冊(cè);2003年04期

9 徐國(guó)輝;張奇;王博;殷兵;陳偉;張英澤;;應(yīng)力分散接骨板實(shí)驗(yàn)研究[J];河北醫(yī)科大學(xué)學(xué)報(bào);2010年08期

，

本文編號(hào)：1395120