發(fā)布時(shí)間：2018-04-29 11:58

  本文選題：穩(wěn)定性 + 肘關(guān)節(jié)��； 參考：《天津科技大學(xué)》2017年碩士論文

【摘要】：近年來,因日�；顒�(dòng)、劇烈的體育運(yùn)動(dòng)及創(chuàng)傷等導(dǎo)致的肘關(guān)節(jié)內(nèi)外側(cè)副韌帶、關(guān)節(jié)囊等損傷所引起的肘關(guān)節(jié)不穩(wěn)定的發(fā)生明顯增加。根據(jù)一些臨床實(shí)驗(yàn)結(jié)果發(fā)現(xiàn),大多數(shù)人在肘關(guān)節(jié)損傷恢復(fù)之后屈曲運(yùn)動(dòng)影響不大,但伸直運(yùn)動(dòng)卻受到嚴(yán)重阻礙,極大地影響了日常生活和工作。目前對(duì)于肘關(guān)節(jié)韌帶及關(guān)節(jié)囊的損傷機(jī)理和修復(fù)尚不清楚,因此構(gòu)建具有高仿真度的成人肘關(guān)節(jié)有限元模型,研究其在屈伸過程中相關(guān)結(jié)構(gòu)的生物力學(xué)特性,對(duì)減少和防護(hù)上肢損傷、維護(hù)肘關(guān)節(jié)功能的穩(wěn)定有重要的理論意義和實(shí)際應(yīng)用價(jià)值。本課題基于正常成人上肢CT掃描數(shù)據(jù),應(yīng)用醫(yī)學(xué)影像處理軟件和逆向工程軟件,提取上肢幾何輪廓,構(gòu)建具有高仿真度的肘關(guān)節(jié)有限元模型(包括肱骨、尺骨和橈骨,肱骨遠(yuǎn)端和尺、橈骨近端關(guān)節(jié)面軟骨,尺側(cè)副韌帶前束、后束和斜束以及橈側(cè)副韌帶)。對(duì)構(gòu)建的肘關(guān)節(jié)有限元模型進(jìn)行有效性驗(yàn)證。并對(duì)肘關(guān)節(jié)進(jìn)行從中立90°位到0°位的屈伸仿真模擬運(yùn)算,其分析基于以下兩種情況,正常情況:有尺側(cè)副韌帶前束、后束和斜束以及橈側(cè)副韌帶;損傷情況(韌帶部分缺失):(1)有尺側(cè)副韌帶后束、斜束以及橈側(cè)副韌帶,無前束;(2)有尺側(cè)副韌帶前束、斜束以及橈側(cè)副韌帶,無后束;(3)有尺側(cè)副韌帶前束、后束以及橈側(cè)副韌帶,無斜束;(4)有尺側(cè)副韌帶前束、后束以及斜束,無橈側(cè)副韌帶。將結(jié)果與以往的文獻(xiàn)資料進(jìn)行對(duì)比分析,驗(yàn)證模型的有效性;研究肘關(guān)節(jié)從中立90°位到0°位伸直運(yùn)動(dòng)的過程中,關(guān)節(jié)面軟骨和相關(guān)韌帶的應(yīng)力分布及大小變化情況。對(duì)正常肘關(guān)節(jié)關(guān)節(jié)面軟骨、尺側(cè)副韌帶和橈側(cè)副韌帶的應(yīng)力情況進(jìn)行分析,結(jié)果表明:本文構(gòu)建的肘關(guān)節(jié)三維有限元模型具有較高的有效性;肘關(guān)節(jié)從中立90°位到0°位伸直運(yùn)動(dòng)的過程中,接觸應(yīng)力最大的部位大都集中在尺骨滑車切跡突處,這與臨床上觀測(cè)大致相符;尺側(cè)副韌帶和橈側(cè)副韌帶所受應(yīng)力大都集中于起、止側(cè)部位,且在肘關(guān)節(jié)伸肘15°之前,橈側(cè)副韌帶起主要作用,伸肘角度超過15°之后起主要作用的是尺側(cè)副韌帶前束,其次是尺側(cè)副韌帶后束,最后是尺側(cè)副韌帶斜束。本研究對(duì)臨床上由關(guān)節(jié)面軟骨磨損嚴(yán)重而導(dǎo)致的關(guān)節(jié)炎疾病以及韌帶的損傷機(jī)理、修復(fù)和重建有一定的指導(dǎo)意義,為運(yùn)動(dòng)醫(yī)學(xué)、臨床醫(yī)學(xué)、康復(fù)醫(yī)學(xué)等提供理論依據(jù),同時(shí)為深入揭示人體肘關(guān)節(jié)運(yùn)動(dòng)規(guī)律、運(yùn)動(dòng)創(chuàng)傷的預(yù)防和康復(fù)、人工關(guān)節(jié)的優(yōu)化設(shè)計(jì)以及肘關(guān)節(jié)穩(wěn)定性的維持提供理論支持。
[Abstract]:In recent years, the instability of elbow joint caused by injuries such as internal and external collateral ligament, joint capsule and so on caused by daily activities, violent sports and trauma has increased significantly. According to the results of some clinical experiments it is found that most people have little effect on flexion motion after the recovery of elbow joint injury but the straightening movement is seriously hindered which greatly affects daily life and work. At present, the damage mechanism and repair of the ligament and capsule of elbow joint are not clear, so the finite element model of adult elbow joint with high imitation degree is constructed, and the biomechanical characteristics of the related structure during the process of flexion and extension are studied. It has important theoretical significance and practical application value in reducing and protecting upper limb injury and maintaining the function stability of elbow joint. Based on CT scan data of normal adult upper limb, the geometric contour of upper limb was extracted by medical image processing software and reverse engineering software, and the finite element model of elbow joint (including humerus, ulna and radius) was constructed. Distal humerus and ulnar, proximal articular cartilage, anterior bundle of ulnar collateral ligament, posterior bundle and oblique bundle, and radial collateral ligament. The validity of the constructed finite element model of elbow joint is verified. The elbow joint was simulated from neutral 90 擄position to 0 擄position. Its analysis was based on the following two conditions: anterior bundle of ulnar collateral ligament, posterior bundle and oblique bundle and radial collateral ligament; Injury (partial loss of ligamentum: 1) posterior bundle of ulnar collateral ligament, oblique bundle and radial collateral ligament, no anterior bundle of collateral ligament, anterior bundle of ulnar collateral ligament, oblique bundle and radial collateral ligament, no posterior bundle, anterior bundle of ulnar collateral ligament, posterior bundle and radial collateral ligament. There were anterior, posterior and oblique ligaments of ulnar collateral ligament, and no radial collateral ligament. The results were compared with previous literatures to verify the validity of the model, and the stress distribution and size of articular surface cartilage and related ligaments were studied during the extension of elbow joint from neutral 90 擄to 0 擄. The stress of articular surface cartilage, ulnar collateral ligament and radial collateral ligament of normal elbow joint is analyzed. The results show that the three-dimensional finite element model of elbow joint constructed in this paper is highly effective. In the process of elbow joint stretching from neutral 90 擄to 0 擄, most of the contact stress is concentrated at the notch of the ulnar trochlear, which is roughly consistent with the clinical observation, and the stress of the ulnar collateral ligament and radial collateral ligament is mostly concentrated. The radial collateral ligament played the main role before the elbow extension was 15 擄, the anterior bundle of the ulnar collateral ligament, the posterior bundle of the ulnar collateral ligament, and the oblique bundle of the ulnar collateral ligament. This study is of guiding significance for the repair and reconstruction of arthritic diseases and ligament damage caused by severe wear of articular cartilage, and provides theoretical basis for sports medicine, clinical medicine, rehabilitation medicine and so on. At the same time, it provides theoretical support for revealing the movement law of human elbow joint, prevention and rehabilitation of sports trauma, optimization design of artificial joint and maintenance of elbow joint stability.
【學(xué)位授予單位】：天津科技大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R68;R318.01

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