髖臼后壁后柱新型解剖鎖定鋼板的研發(fā)及有限元分析
發(fā)布時(shí)間：2018-09-09 12:26
【摘要】：目的:1、建立男、女髖臼后壁后柱表面“點(diǎn)云”數(shù)據(jù)庫(kù),研發(fā)出固定不同類(lèi)型髖臼后壁后柱骨折的新型解剖鎖定鋼板。2、構(gòu)建新型鋼板、雙鋼板以及單鋼板+彈簧鋼板固定累及髖臼后柱伴后壁骨折的模型,并運(yùn)用有限元分析法(Finite Element Method,FEM)進(jìn)行分析,比較三種固定方式的穩(wěn)定性。方法:1、建立髖臼后壁后柱表面“點(diǎn)云”數(shù)據(jù)庫(kù)收集200例正常成人骨盆CT數(shù)據(jù),男、女各100例,男性平均年齡為48.5歲,女性平均年齡為50.8歲,排除骨盆髖臼骨折、腫瘤等病變。將以上骨盆CT數(shù)據(jù)導(dǎo)入Mimics17.0軟件進(jìn)行三維重建,分別測(cè)量男、女髖臼緣最高點(diǎn)A至髖臼緣最低點(diǎn)B的弧長(zhǎng)AB值,分別將AB值按升序排列選取第50位骨盆標(biāo)本作為男、女標(biāo)準(zhǔn)骨盆,將其轉(zhuǎn)換為點(diǎn)云文件,即獲得髖臼后壁后柱區(qū)域的“點(diǎn)云”數(shù)據(jù)庫(kù)。2、髖臼后壁后柱新型鋼板的設(shè)計(jì)將髖臼后壁后柱表面“點(diǎn)云”文件導(dǎo)入Geomagic Studio 13軟件進(jìn)行三角面片網(wǎng)格重建,然后對(duì)獲得的標(biāo)準(zhǔn)骨盆模型進(jìn)行優(yōu)化、光順處理,以STL格式保存后導(dǎo)入至Imageware13.0軟件進(jìn)行鋼板底面設(shè)計(jì)。根據(jù)臨床髖臼后壁后柱骨折的類(lèi)型,將新型鋼板設(shè)計(jì)為高位型、非高位型。高位型鋼板主要用于固定髖臼后壁后上部骨折,由三部分組成:(1)髖臼后上部分:位于髖臼負(fù)重區(qū)。(2)髖臼后部:鋼板覆蓋后部大部分區(qū)域。(3)坐骨部分:起始于髖臼下緣與坐骨體交界的扭轉(zhuǎn)處,鋼板向坐骨體后表面延伸。非高位型鋼板主要用于固定位于后部的髖臼后壁骨折,包含三個(gè)部分:(1)髂骨部分,始于髖臼后壁近端的髂骨,位于臀上血管神經(jīng)束的外側(cè)。(2)髖臼后部和(3)坐骨部分與高位型一致。根據(jù)上述要求,應(yīng)用imageware13.0軟件在髖臼后壁后柱表面分別繪制出兩種鋼板底面,調(diào)節(jié)控制點(diǎn)使鋼板底面與骨面形態(tài)相服帖。隨后將鋼板底面以igs格式導(dǎo)入ug9.0軟件中,拉厚鋼板底面,并對(duì)其添加圓邊、圓角以及預(yù)彎槽等特征。依次在鋼板的三個(gè)部分添加螺孔:(1)在高位型鋼板的后上部分和非高位型鋼板的髂骨部分添加橢圓形普通螺釘孔;(2)在鋼板髖臼后部的外側(cè)1/3添加圓形鎖定螺釘孔,螺釘孔方向避開(kāi)髖關(guān)節(jié)腔,且各孔方向延長(zhǎng)線不交叉;內(nèi)側(cè)2/3添加橢圓形普通螺釘孔;(3)在鋼板坐骨部分添加橢圓形普通螺釘孔。所有的橢圓形普通螺孔方向與鋼板平面垂直。3、鋼板有限元分析我們將標(biāo)準(zhǔn)骨盆模型導(dǎo)入geomagicstudio13軟件建立有限元分析模型,轉(zhuǎn)化為nurbs封閉曲面骨盆模型,以igs格式文件保存后導(dǎo)入solidworks2016軟件,分別人為制造累及髖臼高位和非高位的后柱伴后壁骨折模型,同時(shí)構(gòu)建出雙鋼板模型和單鋼板+彈簧鋼板模型,以igs格式導(dǎo)入solidworks2016軟件中,按照三種鋼板相應(yīng)的內(nèi)固定方式分別裝配在兩種骨折模型上得到新型鋼板固定模型、雙鋼板固定模型以及單鋼板+彈簧鋼板固定模型。運(yùn)用hypermesh12.0軟件將獲得的六種固定模型進(jìn)行網(wǎng)格劃分,然后以inp格式文件保存后導(dǎo)入abaqus6.14軟件,分別對(duì)鋼板、螺釘及骨盆進(jìn)行賦值,螺釘與骨質(zhì)之間設(shè)為綁定連接關(guān)系,作以下靜力分析:(1)垂直方向靜力分析:固定雙側(cè)髖臼窩,限制6個(gè)自由度的活動(dòng),分別在六種髖臼骨折固定模型的骶1椎體上表面施加500n上下方向垂直載荷;(2)前后方向靜力分析:約束骶骨后部,限制6個(gè)自由度的活動(dòng),分別在六種髖臼骨折固定模型的恥骨聯(lián)合前表面上施加500n前后方向載荷;(3)側(cè)方靜力分析:固定右側(cè)髖臼窩,限制6個(gè)自由度的活動(dòng),分別在六種髖臼骨折固定模型的左側(cè)髂骨外板表面施加500n水平方向載荷。分析不同內(nèi)固定方式在三種載荷加載情況下的vonmises應(yīng)力分布和位移分布。結(jié)果:1、通過(guò)對(duì)200例正常成人骨盆標(biāo)本測(cè)量后,我們得到髖臼緣最高點(diǎn)a至髖臼緣最低點(diǎn)b的弧長(zhǎng)ab值男性為(82.00±5.62)mm,女性為(73.77±5.07)mm,其差異具有統(tǒng)計(jì)學(xué)意義(p0.05)。我們將ab值按升序排列后得到第50位髖臼ab弧長(zhǎng)分別為82.06mm(男)、73.50mm(女),以此作為男、女標(biāo)準(zhǔn)髖臼并保存為點(diǎn)云文件,即獲得髖臼后壁后柱表面的“點(diǎn)云”數(shù)據(jù)庫(kù)。2、將男、女標(biāo)準(zhǔn)骨盆的點(diǎn)云文件導(dǎo)入geomagicstudio13軟件進(jìn)行三角面片網(wǎng)格重建,然后利用imageware13.0軟件在骨盆表面相應(yīng)位置虛擬出鋼板形態(tài),通過(guò)調(diào)節(jié)控制點(diǎn)使鋼板底面與骨面形態(tài)相服帖,將鋼板底面導(dǎo)入ug9.0軟件拉厚至2.5mm,并添加0.3mm圓邊、2mm圓角以及預(yù)彎槽等特征。高位型鋼板由三部分組成:(1)髖臼后上部分:位于髖臼負(fù)重區(qū),鋼板頂端距離髂前下棘2.0cm,邊緣距離髖臼外側(cè)緣0.6cm,鋼板長(zhǎng)約2.0cm,寬度為1.0cm,添加有長(zhǎng)徑為6mm,短徑為4mm的橢圓形普通螺釘孔2-3枚。(2)髖臼后部:鋼板邊緣距髖臼外側(cè)緣0.6cm,男性鋼板最大寬度為3.0cm,女性鋼板最大寬度為2.5cm。外側(cè)1/3部分添加有直徑為2.7mm的圓形鎖定螺釘孔5-6枚,內(nèi)側(cè)2/3部分添加有長(zhǎng)徑為6mm,短徑為4mm的橢圓形普通螺釘孔7-11枚。(3)坐骨部分:鋼板長(zhǎng)約2.0cm,寬度為1.0cm,添加有長(zhǎng)徑為6mm,短徑為4mm的橢圓形普通螺釘孔2枚。非高位型鋼板包含三個(gè)部分:(1)髂骨部分,鋼板長(zhǎng)約2.0cm,寬度為1.0cm,添加有長(zhǎng)徑為6mm,短徑為4mm的橢圓形普通螺釘孔2-3枚。(2)髖臼后部和(3)坐骨部分與高位型一致。所有的橢圓形普通螺孔方向與鋼板平面垂直,所有的圓形鎖定螺釘孔方向避開(kāi)髖關(guān)節(jié)腔,且各孔方向延長(zhǎng)線不交叉。3、成功構(gòu)建六種固定髖臼后壁后柱骨折的有限元分析模型。髖臼高位骨折模型后柱骨折線接近于坐骨大切跡水平,后壁骨折塊靠近髖臼后上方,近端骨折塊最大上下徑為6.5mm,最大內(nèi)外徑為14mm,遠(yuǎn)端骨折塊最大上下徑為18mm,最大內(nèi)外徑為12mm,骨折端分離0.5mm;髖臼非高位骨折模型后柱骨折線接近于髖臼后柱中部,后壁骨折塊靠近髖臼后壁后方,近端骨折塊最大上下徑為6.4mm,最大內(nèi)外徑為14mm,遠(yuǎn)端骨折塊最大上下徑為19mm,最大內(nèi)外徑為12mm,骨折端分離0.5mm。兩種骨折模型均在恥骨下支中部離端,骨折端分離0.5mm。垂直方向靜力分析:(1)三種髖臼高位骨折固定模型:新型鋼板、雙鋼板以及單鋼板+彈簧鋼板的最大位移分別為0.16mm、0.12mm、0.17mm,最大位移均位于左側(cè)髂嵴處。骨盆受到的最大應(yīng)力分別為24mpa、15mpa、31mpa;鋼板受到的最大應(yīng)力分別為48mpa、127mpa、38mpa。(2)三種髖臼非高位骨折固定模型:新型鋼板、雙鋼板以及單鋼板+彈簧鋼板的最大位移分別為0.17mm、0.15mm、0.18mm,最大位移均位于左側(cè)髂嵴處。骨盆受到的最大應(yīng)力分別為26mpa、34mpa、39mpa;鋼板受到的最大應(yīng)力分別為37mpa、213mpa、113mpa。前后方向靜力分析:(1)三種髖臼高位骨折固定模型:新型鋼板、雙鋼板以及單鋼板+彈簧鋼板的最大位移分別為0.19mm、0.21mm、0.19mm,最大位移均位于左側(cè)恥骨下支骨折處。骨盆受到的最大應(yīng)力分別為45mpa、72mpa、23mpa;鋼板受到的最大應(yīng)力分別為5.9mpa、9mpa、9.8mpa。(2)三種髖臼非高位骨折固定模型:新型鋼板、雙鋼板以及單鋼板+彈簧鋼板的最大位移分別為0.19mm、0.22mm、0.24mm,最大位移均位于左側(cè)恥骨下支骨折處。骨盆受到的最大應(yīng)力分別為46mpa、72mpa、79mpa;鋼板受到的最大應(yīng)力分別為8.9mpa、18mpa、9.5mpa。側(cè)方靜力分析:(1)三種髖臼高位骨折固定模型:新型鋼板、雙鋼板以及單鋼板+彈簧鋼板的最大位移分別為2.30mm、4.59mm、4.85mm,最大位移均位于右側(cè)髂嵴處。骨盆受到的最大應(yīng)力分別為168MPa、330MPa、272MPa;鋼板受到的最大應(yīng)力分別為268MPa、683MPa、782MPa。(2)三種髖臼非高位骨折固定模型:新型鋼板、雙鋼板以及單鋼板+彈簧鋼板的最大位移分別為2.04mm、2.90mm、5.60mm,最大位移均位于右側(cè)髂嵴處。骨盆受到的最大應(yīng)力分別為108MPa、196MPa、269MPa;鋼板受到的最大應(yīng)力分別為334MPa、649MPa、698MPa。結(jié)論:1、根據(jù)髖臼后壁后柱表面解剖特點(diǎn)成功設(shè)計(jì)出與之相服帖的不同性別的兩種新型解剖鎖定鋼板。2、新型鋼板分為一體兩翼,鋼板上的螺孔為橢圓形普通孔與圓形鎖定孔,橢圓形普通孔位于鋼板的兩翼和體部的內(nèi)側(cè)2/3,便于術(shù)中根據(jù)骨折線調(diào)整螺釘方向;圓形鎖定孔位于體部的外側(cè)1/3,可固定髖臼后壁的小骨折塊。相對(duì)于雙鋼板、單鋼板+彈簧鋼板固定,新型鋼板覆蓋范圍更廣泛,應(yīng)力分布更均勻。
[Abstract]:Objective: 1. To establish a "point cloud" database of the posterior column surface of acetabulum for both men and women, and to develop a new type of anatomical locking plate for fixation of different types of posterior column fractures of acetabulum. Methods: 1. Set up the "point cloud" database of the posterior column surface of acetabulum to collect the CT data of 200 normal adults, 100 males and 100 females, the average age of males is 48.5 years, the average age of females is 50.8 years, excluding the pelvic acetabular fracture, tumor and other lesions. Mimics 17.0 software was imported to carry out three-dimensional reconstruction, and the AB values of the highest point A of the acetabular margin and the lowest point B of the acetabular margin of the male and female were measured respectively. The 50th pelvic specimens were selected as male and female standard pelvis according to ascending order of AB values. They were converted into point cloud files, that is, the "point cloud" database of the posterior column of the acetabular wall was obtained. The design of the new steel plate for the posterior column of the acetabulum introduces the "point cloud" file into Geomagic Studio 13 software for triangular mesh reconstruction, then optimizes the obtained standard pelvic model, smoothes it, saves it in STL format and imports it into Imageware 13.0 software for the design of the steel plate bottom. According to the clinical acetabulum posterior column, the steel plate is designed. The high plate is mainly used to fix the posterior and upper part of the acetabulum. It consists of three parts: (1) the posterior and upper part of the acetabulum is located in the acetabulum load-bearing area. (2) the posterior part of the acetabulum: the plate covers most of the posterior area. (3) the ischial part: the torsion that begins at the junction of the lower acetabulum and the ischium. The non-high plate is mainly used to fix the posterior acetabular wall fractures located at the posterior part of the acetabulum. It consists of three parts: (1) the iliac part, which begins at the proximal end of the posterior wall of the acetabulum, is located at the lateral of the superior gluteal vascular nerve bundle. (2) the posterior acetabulum and (3) the sciatic part are consistent with the high type. Ware13.0 software draws two kinds of steel plate bottoms on the surface of the posterior column of the acetabular posterior wall, and adjusts the control points to make the steel plate bottoms conform to the shape of the bone surface. (1) Ordinary elliptical screw holes were added to the upper and posterior parts of the high profile plate and the iliac part of the non-high profile plate; (2) Round locking screw holes were added to the lateral part of the posterior acetabulum of the plate, the direction of the screw holes avoided the hip joint cavity, and the lengthening lines of the holes were not intersected; the medial part 2/3 added elliptical ordinary screw holes; (3) Sciatic part of the plate was added to the plate. All the elliptical common screw holes are perpendicular to the plane of the plate. 3. Finite element analysis of the plate. We imported the standard pelvic model into the Geomagic studio 13 software to establish the finite element analysis model, transformed it into a NURBS closed-form pelvic model, saved in IGS format file and imported SolidWorks 2016 software, respectively. In order to make a model of posterior column fracture with posterior wall involving high and non-high acetabulum, a double-plate model and a single-plate plus spring-plate model were constructed. The SolidWorks 2016 software was imported in IGS format, and a new type of plate fixation model was established according to the corresponding internal fixation methods of three plates. The six fixed models were meshed by HyperMesh 12.0 software, and then were saved in InP format file and imported into ABAQUS 6.14 software. The plate, screw and pelvis were assigned, and the relationship between screw and bone was set as binding connection. The static analysis was as follows: (1) Vertical. Directional static analysis: Fixation of bilateral acetabular fossa, restriction of six degrees of freedom of movement, respectively in the six acetabular fracture fixation model of the upper surface of the sacral 1 vertebral body applied 500 N vertical load; (2) Anterior and posterior static analysis: constraints on the posterior sacrum, restriction of six degrees of freedom of movement, respectively in the six acetabular fracture fixation model of the pubic symphysis before. (3) Lateral static analysis: Fixation of the right acetabular fossa, restriction of six degrees of freedom, and application of 500 N horizontal loads on the surface of the left iliac outer plate of six kinds of acetabular fracture fixation models. Results: 1. After measuring 200 normal adult pelvic specimens, we found that the a b value of the highest point of acetabular margin a to the lowest point of acetabular margin B was (82.00.62) mm in males and (73.77.07) mm in females. The difference was statistically significant (p0.05). 73.50mm (female) as the male and female standard acetabulum and saved as a point cloud file, that is, the "point cloud" database of the posterior column surface of the acetabulum was obtained. 2. The point cloud files of the male and female standard pelvis were imported into Geomagic studio 13 software to reconstruct the triangular patch mesh, and then the plate was dummied out at the corresponding position on the pelvic surface by using Imageware 13.0 software. The bottom of the plate was drawn to 2.5mm by ug9.0 software, and 0.3mm round edge, 2mm Round Corner and pre-bending groove were added. The high profile plate consists of three parts: (1) the upper part of the acetabulum is located in the acetabular load-bearing area, the top of the plate is 2.0cm away from the anterior inferior iliac spine, and the edge is 2.0cm away from the acetabulum. The lateral margin of acetabulum was 0.6 cm, the steel plate was 2.0 cm in length and 1.0 cm in width. There were 2-3 oval common screw holes with 6 mm in length and 4 mm in short diameter. (3) Sciatic part: plate length is about 2.0 cm, width is 1.0 cm, add 2 oval common screw holes with 6 mm in length and 4 mm in diameter. Non-high plate contains three parts: (1) iliac part, plate length is about 2.0 cm, width is 1.0 cm, add 2 oval common screw holes with 6 mm in length and 4 mm in diameter. (2) The posterior part of the acetabulum and (3) the ischium are consistent with the high position type. All the oval common screw holes are perpendicular to the plate plane. All the circular locking screw holes avoid the acetabular joint cavity and the lengthening lines of each hole are not intersected. 3. Six kinds of fixed acetabulum posterior wall were successfully constructed. The fracture line of the posterior column of the high acetabular fracture model is close to the level of the great sciatic notch. The posterior wall of the fracture block is close to the top of the posterior acetabulum. The maximum upper and lower diameters of the proximal fracture block are 6.5 mm, the maximum internal and external diameters are 14 mm, the maximum upper and lower diameters of the distal fracture block are 18 mm, the maximum internal and external diameters are 12 mm, and the fracture ends are separated by 0.5 mm. The fracture line of the posterior column of the high fracture model is close to the middle of the posterior column of the acetabulum. The posterior wall fracture block is close to the posterior wall of the acetabulum. The maximum upper and lower diameters of the proximal fracture block are 6.4 mm, the maximum internal and external diameters are 14 mm, the maximum upper and lower diameters of the distal fracture block are 19 mm, the maximum internal and external diameters are 12 mm, and the fracture ends are separated by 0.5 mm. Vertical static analysis of fracture end separation 0.5 mm: (1) The maximum displacement of three high acetabular fracture fixation models were 0.16 mm, 0.12 mm, 0.17 mm, respectively. The maximum stress of pelvis was 24 mpa, 15 mpa, 31 mpa, and the maximum stress of plate was 0.16 mm, 0.12 mm, and 0.17 mm, respectively. The maximum displacement of the new plate, double plate and single plate plus spring plate were 0.17 mm, 0.15 mm and 0.18 mm respectively. the maximum displacement was located at the left iliac crest. Mpa, 113mpa. Anterior and posterior static analysis: (1) Three high acetabular fracture fixation models: new plate, double plate and single plate + spring plate, the maximum displacement were 0.19 mm, 0.21 mm, 0.19 mm, respectively. The maximum displacement was located at the left inferior pubic branch fracture. The maximum stress of pelvis was 45 mpa, 72 mpa, 23 mpa, and the maximum displacement of plate was 0.19 mm, 0.21 mm, 0.19 mm, respectively. (2) The maximum displacements of the new plate, double plate and single plate plus spring plate were 0.19 mm, 0.22 mm and 0.24 mm respectively. The maximum displacements were located at the fracture site of the left inferior pubic branch. The lateral static analysis was 8.9 mpa, 18 mpa, and 9.5 mpa, respectively. (1) The maximum displacements of three high acetabular fracture fixation models were 2.30 mm, 4.59 mm, 4.85 mm, respectively. The maximum stresses on the pelvis were 168 MPa, 330 MPa, 272 MPa, and the maximum displacements on the plate were 2.30 mm, 4.59 mm, 4.85 mm, respectively. The stress was 268 MPa, 683 MPa and 782 MPa. (2) The maximum displacement of the new plate, double plate and single plate plus spring plate were 2.04 mm, 2.90 mm and 5.60 mm respectively, and the maximum displacement was located at the right iliac crest. Conclusion: 1. According to the anatomical characteristics of the posterior column of the acetabular posterior wall, two new anatomical locking plates of different genders were successfully designed. 2. The new plate was divided into one body and two wings. The screw holes on the plate were oval ordinary holes and circular locking holes. The oval ordinary holes were located on the wings and body parts of the plate. Medial 2/3, easy to adjust the direction of the screw according to the fracture line during the operation; circular locking hole is located in the lateral part of the body 1/3, can fix acetabular posterior wall of small fractures. Compared with double plates, single plate + spring plate fixation, the new plate coverage is wider, stress distribution is more uniform.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R687.3
本文編號(hào)：2232370
[Abstract]:Objective: 1. To establish a "point cloud" database of the posterior column surface of acetabulum for both men and women, and to develop a new type of anatomical locking plate for fixation of different types of posterior column fractures of acetabulum. Methods: 1. Set up the "point cloud" database of the posterior column surface of acetabulum to collect the CT data of 200 normal adults, 100 males and 100 females, the average age of males is 48.5 years, the average age of females is 50.8 years, excluding the pelvic acetabular fracture, tumor and other lesions. Mimics 17.0 software was imported to carry out three-dimensional reconstruction, and the AB values of the highest point A of the acetabular margin and the lowest point B of the acetabular margin of the male and female were measured respectively. The 50th pelvic specimens were selected as male and female standard pelvis according to ascending order of AB values. They were converted into point cloud files, that is, the "point cloud" database of the posterior column of the acetabular wall was obtained. The design of the new steel plate for the posterior column of the acetabulum introduces the "point cloud" file into Geomagic Studio 13 software for triangular mesh reconstruction, then optimizes the obtained standard pelvic model, smoothes it, saves it in STL format and imports it into Imageware 13.0 software for the design of the steel plate bottom. According to the clinical acetabulum posterior column, the steel plate is designed. The high plate is mainly used to fix the posterior and upper part of the acetabulum. It consists of three parts: (1) the posterior and upper part of the acetabulum is located in the acetabulum load-bearing area. (2) the posterior part of the acetabulum: the plate covers most of the posterior area. (3) the ischial part: the torsion that begins at the junction of the lower acetabulum and the ischium. The non-high plate is mainly used to fix the posterior acetabular wall fractures located at the posterior part of the acetabulum. It consists of three parts: (1) the iliac part, which begins at the proximal end of the posterior wall of the acetabulum, is located at the lateral of the superior gluteal vascular nerve bundle. (2) the posterior acetabulum and (3) the sciatic part are consistent with the high type. Ware13.0 software draws two kinds of steel plate bottoms on the surface of the posterior column of the acetabular posterior wall, and adjusts the control points to make the steel plate bottoms conform to the shape of the bone surface. (1) Ordinary elliptical screw holes were added to the upper and posterior parts of the high profile plate and the iliac part of the non-high profile plate; (2) Round locking screw holes were added to the lateral part of the posterior acetabulum of the plate, the direction of the screw holes avoided the hip joint cavity, and the lengthening lines of the holes were not intersected; the medial part 2/3 added elliptical ordinary screw holes; (3) Sciatic part of the plate was added to the plate. All the elliptical common screw holes are perpendicular to the plane of the plate. 3. Finite element analysis of the plate. We imported the standard pelvic model into the Geomagic studio 13 software to establish the finite element analysis model, transformed it into a NURBS closed-form pelvic model, saved in IGS format file and imported SolidWorks 2016 software, respectively. In order to make a model of posterior column fracture with posterior wall involving high and non-high acetabulum, a double-plate model and a single-plate plus spring-plate model were constructed. The SolidWorks 2016 software was imported in IGS format, and a new type of plate fixation model was established according to the corresponding internal fixation methods of three plates. The six fixed models were meshed by HyperMesh 12.0 software, and then were saved in InP format file and imported into ABAQUS 6.14 software. The plate, screw and pelvis were assigned, and the relationship between screw and bone was set as binding connection. The static analysis was as follows: (1) Vertical. Directional static analysis: Fixation of bilateral acetabular fossa, restriction of six degrees of freedom of movement, respectively in the six acetabular fracture fixation model of the upper surface of the sacral 1 vertebral body applied 500 N vertical load; (2) Anterior and posterior static analysis: constraints on the posterior sacrum, restriction of six degrees of freedom of movement, respectively in the six acetabular fracture fixation model of the pubic symphysis before. (3) Lateral static analysis: Fixation of the right acetabular fossa, restriction of six degrees of freedom, and application of 500 N horizontal loads on the surface of the left iliac outer plate of six kinds of acetabular fracture fixation models. Results: 1. After measuring 200 normal adult pelvic specimens, we found that the a b value of the highest point of acetabular margin a to the lowest point of acetabular margin B was (82.00.62) mm in males and (73.77.07) mm in females. The difference was statistically significant (p0.05). 73.50mm (female) as the male and female standard acetabulum and saved as a point cloud file, that is, the "point cloud" database of the posterior column surface of the acetabulum was obtained. 2. The point cloud files of the male and female standard pelvis were imported into Geomagic studio 13 software to reconstruct the triangular patch mesh, and then the plate was dummied out at the corresponding position on the pelvic surface by using Imageware 13.0 software. The bottom of the plate was drawn to 2.5mm by ug9.0 software, and 0.3mm round edge, 2mm Round Corner and pre-bending groove were added. The high profile plate consists of three parts: (1) the upper part of the acetabulum is located in the acetabular load-bearing area, the top of the plate is 2.0cm away from the anterior inferior iliac spine, and the edge is 2.0cm away from the acetabulum. The lateral margin of acetabulum was 0.6 cm, the steel plate was 2.0 cm in length and 1.0 cm in width. There were 2-3 oval common screw holes with 6 mm in length and 4 mm in short diameter. (3) Sciatic part: plate length is about 2.0 cm, width is 1.0 cm, add 2 oval common screw holes with 6 mm in length and 4 mm in diameter. Non-high plate contains three parts: (1) iliac part, plate length is about 2.0 cm, width is 1.0 cm, add 2 oval common screw holes with 6 mm in length and 4 mm in diameter. (2) The posterior part of the acetabulum and (3) the ischium are consistent with the high position type. All the oval common screw holes are perpendicular to the plate plane. All the circular locking screw holes avoid the acetabular joint cavity and the lengthening lines of each hole are not intersected. 3. Six kinds of fixed acetabulum posterior wall were successfully constructed. The fracture line of the posterior column of the high acetabular fracture model is close to the level of the great sciatic notch. The posterior wall of the fracture block is close to the top of the posterior acetabulum. The maximum upper and lower diameters of the proximal fracture block are 6.5 mm, the maximum internal and external diameters are 14 mm, the maximum upper and lower diameters of the distal fracture block are 18 mm, the maximum internal and external diameters are 12 mm, and the fracture ends are separated by 0.5 mm. The fracture line of the posterior column of the high fracture model is close to the middle of the posterior column of the acetabulum. The posterior wall fracture block is close to the posterior wall of the acetabulum. The maximum upper and lower diameters of the proximal fracture block are 6.4 mm, the maximum internal and external diameters are 14 mm, the maximum upper and lower diameters of the distal fracture block are 19 mm, the maximum internal and external diameters are 12 mm, and the fracture ends are separated by 0.5 mm. Vertical static analysis of fracture end separation 0.5 mm: (1) The maximum displacement of three high acetabular fracture fixation models were 0.16 mm, 0.12 mm, 0.17 mm, respectively. The maximum stress of pelvis was 24 mpa, 15 mpa, 31 mpa, and the maximum stress of plate was 0.16 mm, 0.12 mm, and 0.17 mm, respectively. The maximum displacement of the new plate, double plate and single plate plus spring plate were 0.17 mm, 0.15 mm and 0.18 mm respectively. the maximum displacement was located at the left iliac crest. Mpa, 113mpa. Anterior and posterior static analysis: (1) Three high acetabular fracture fixation models: new plate, double plate and single plate + spring plate, the maximum displacement were 0.19 mm, 0.21 mm, 0.19 mm, respectively. The maximum displacement was located at the left inferior pubic branch fracture. The maximum stress of pelvis was 45 mpa, 72 mpa, 23 mpa, and the maximum displacement of plate was 0.19 mm, 0.21 mm, 0.19 mm, respectively. (2) The maximum displacements of the new plate, double plate and single plate plus spring plate were 0.19 mm, 0.22 mm and 0.24 mm respectively. The maximum displacements were located at the fracture site of the left inferior pubic branch. The lateral static analysis was 8.9 mpa, 18 mpa, and 9.5 mpa, respectively. (1) The maximum displacements of three high acetabular fracture fixation models were 2.30 mm, 4.59 mm, 4.85 mm, respectively. The maximum stresses on the pelvis were 168 MPa, 330 MPa, 272 MPa, and the maximum displacements on the plate were 2.30 mm, 4.59 mm, 4.85 mm, respectively. The stress was 268 MPa, 683 MPa and 782 MPa. (2) The maximum displacement of the new plate, double plate and single plate plus spring plate were 2.04 mm, 2.90 mm and 5.60 mm respectively, and the maximum displacement was located at the right iliac crest. Conclusion: 1. According to the anatomical characteristics of the posterior column of the acetabular posterior wall, two new anatomical locking plates of different genders were successfully designed. 2. The new plate was divided into one body and two wings. The screw holes on the plate were oval ordinary holes and circular locking holes. The oval ordinary holes were located on the wings and body parts of the plate. Medial 2/3, easy to adjust the direction of the screw according to the fracture line during the operation; circular locking hole is located in the lateral part of the body 1/3, can fix acetabular posterior wall of small fractures. Compared with double plates, single plate + spring plate fixation, the new plate coverage is wider, stress distribution is more uniform.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R687.3
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