本文關鍵詞：股骨骨折內固定金屬接骨板的生物力學性能研究　出處：《西南交通大學》2017年碩士論文　論文類型：學位論文

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

【摘要】：隨著生物學固定理念的不斷完善,鎖定加壓接骨板被廣泛應用于骨折內固定治療。與過分強調解剖復位的堅強內固定相比,生物學固定(彈性固定)允許骨折斷端存在一定程度的微動,并認為微動能促進骨痂形成,進而誘導骨折的間接愈合。間接愈合過程對骨折端的力學環(huán)境極為敏感,任何不適宜的應力都可能導致骨折延遲愈合甚至不愈合等臨床并發(fā)癥。內固定系統(tǒng)的穩(wěn)定性是影響骨折端力學環(huán)境的重要因素之一,而接骨板本身的設計參數(shù)和力學性能及接骨板在臨床手術中的固定方式等諸多因素對內固定系統(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內固定系統(tǒng)的影響,研究結果可為臨床內固定手術操作提供一定參考,也可為接骨板的優(yōu)化設計提供理論依據(jù)。本文通過建立股骨干中段橫形骨折內固定系統(tǒng)的有限元模型,采用數(shù)值模擬方法,以骨折塊應變理論為基礎,模擬了骨折愈合早期的動態(tài)愈合過程,考察了接骨板固定參數(shù)(植入螺釘數(shù)量、固定位置、螺釘預緊力等)、接骨板材料和長度對骨折愈合過程的影響,分析了骨折間隙與接骨板材料和長度的匹配關系。主要結果和結論總結如下:(1)接骨板的固定參數(shù)會顯著影響骨折的愈合過程。螺釘預緊力對骨折愈合中骨痂發(fā)育、股骨和接骨板上的應力分布均無顯著影響,但股骨上螺釘孔處的最大應力隨螺釘預緊力增大而增大;采用8孔鎖定加壓接骨板固定股骨干橫形骨折時,骨折線兩側的骨折塊上應植入的螺釘數(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相關。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:相同材質的金屬接骨板,當骨折間隙較大時,應選擇板長較長的接骨板,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力遮擋率均較高,無明顯差異,接骨板材料主要通過影響骨痂彈性模量而對應力遮擋率產生影響。
[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.
【學位授予單位】：西南交通大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687.3;R318.01

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