【摘要】：脛骨骨折是一種較為常見的長管狀骨折,髓內(nèi)釘固定術(shù)是其手術(shù)治療的主要方法之一。目前臨床上應(yīng)用的帶鎖髓內(nèi)釘大都為靜力性固定,存在著較高的應(yīng)力遮擋效應(yīng)和鎖釘疲勞斷裂等缺陷,這將影響骨折的愈合并增加患者的痛苦,阻礙了其臨床應(yīng)用的發(fā)展,因而尋求一種既能使骨折斷端固定可靠,又能使消除應(yīng)力遮擋效應(yīng)的髓內(nèi)釘及鎖釘是臨床需要迫切解決的一個(gè)問題。為此,課題組設(shè)計(jì)出了帶鎖髓內(nèi)釘?shù)摹鞍糸承巍备呗菁y鎖釘,期望它能有效地降低臨床上的鎖釘斷裂風(fēng)險(xiǎn),實(shí)現(xiàn)髓內(nèi)釘靜動自動轉(zhuǎn)變以消除高應(yīng)力遮擋效應(yīng),給骨折的愈合創(chuàng)造一個(gè)較好的力學(xué)環(huán)境。然而,“棒槌形”高螺紋鎖釘?shù)牧W(xué)性能還需通過一系列分析研究。目的:研究“棒槌形”高螺紋鎖釘?shù)牧W(xué)性能,驗(yàn)證其力學(xué)優(yōu)勢,為其臨床應(yīng)用提供理論基礎(chǔ)和科學(xué)依據(jù)。方法:以國人脛骨髓腔測量數(shù)據(jù)為依據(jù),按跨距30mm、40mm、50mm分為A、B、C三組,根據(jù)鎖釘在骨折固定時(shí)的實(shí)際受力情形設(shè)計(jì)出相應(yīng)的試驗(yàn)夾具,并按跨距加工出所需的試驗(yàn)用鎖釘,通過三點(diǎn)彎曲力學(xué)測試檢測其彎曲強(qiáng)度并與通用鎖釘進(jìn)行對照。以CT掃描獲取的脛骨二維斷層數(shù)據(jù)為基礎(chǔ),運(yùn)用Mimics、Geomagic Studio等軟件構(gòu)造脛骨三維實(shí)體模型,利用Pro/E軟件建立髓內(nèi)釘和“棒槌形”鎖釘及通用鎖釘模型并與脛骨三維實(shí)體模型裝配,導(dǎo)入ANSYS軟件構(gòu)造兩種不同鎖釘?shù)膸фi髓內(nèi)釘固定脛骨骨折,模擬雙足站立、單足站立、慢步行走及扭轉(zhuǎn)等狀況下脛骨受力進(jìn)行有限元分析。結(jié)果:力學(xué)測試結(jié)果顯示,在彈性應(yīng)變范圍內(nèi)不同跨距三組中“棒槌形”鎖釘?shù)钠骄畲髲澢d荷均高于通用鎖釘?shù)钠骄畲髲澢d荷,其中A、B、C三組“棒槌形”鎖釘?shù)钠骄畲髲澢d荷相對于通用鎖釘分別提高了14.71%,14.51%,23.84%。有限元分析結(jié)果顯示,在不同工況下使用“棒槌形”鎖釘與使用通用鎖釘固定的脛骨骨折模型和帶鎖髓內(nèi)釘模型的最大Von Mises應(yīng)力值和最大位移基本一致,應(yīng)力分布情況基本相似;而不同位置“棒槌形”鎖釘?shù)淖畲骎on Mises應(yīng)力值和最大位移均明顯低于通用鎖釘?shù)?且應(yīng)力向鎖釘兩端分散。結(jié)論:“棒槌形”鎖釘比通用鎖釘?shù)目箯澢鷱?qiáng)度高,其應(yīng)力向鎖釘兩端分散,不易發(fā)生疲勞斷裂,故其力學(xué)性能優(yōu)于通用鎖釘。
[Abstract]:Tibial fracture is a common long-tube fracture, intramedullary nail fixation is one of the main methods of its surgical treatment. At present, most of the interlocking intramedullary nails used in clinic are static fixation, which has high stress blocking effect and fatigue fracture of locking nail, which will affect the healing of fracture and increase the pain of patients, and hinder the development of its clinical application. Therefore, it is an urgent problem to seek a kind of intramedullary nail and locking nail which can not only make the fracture end fixation reliable, but also eliminate the stress occlusion effect. In order to reduce the risk of nail breakage in clinic and realize the automatic transformation of intramedullary nail static and dynamic to eliminate the high stress occlusion effect, the research group designed a "stick mallet" high thread locking nail with interlocking nail, which is expected to effectively reduce the risk of nail breakage in clinical practice. To create a better mechanical environment for fracture healing. However, the mechanical properties of the high thread locking nail need a series of analysis and research. Objective: to study the mechanical properties of "bar-mallet" high thread locking nail, to verify its mechanical advantages, and to provide theoretical and scientific basis for its clinical application. Methods: according to the measurement data of Chinese tibial medullary cavity, the patients were divided into three groups according to the span of 30mm to 40mm and 50mm. According to the actual force of locking nail during fracture fixation, the corresponding experimental fixture was designed. The test locking nail was manufactured according to the span. The bending strength of the nail was measured by three point bending mechanics test and compared with that of the common locking nail. Based on the two-dimensional fault data of tibia obtained by CT scanning, a three-dimensional solid model of tibia was constructed by using Mimics,Geomagic Studio and other software. Intramedullary nail, "bar mallet" locking nail and common nail model were established with Pro/E software and assembled with tibial three-dimensional solid model. Two kinds of interlocking intramedullary nails were introduced into ANSYS software to fix tibial fracture, and the standing of tibial fractures was simulated by using two kinds of interlocking intramedullary nails. The finite element analysis of tibia force was carried out under the condition of standing on one foot, walking slowly and torsion. Results: the results of mechanical tests showed that the average maximum bending load of the "bar" locking nail was higher than that of the common locking nail in the three groups with different span in the elastic strain range, among which the average maximum bending load of the "bar" locking nail was higher than that of the common locking nail. The average maximum bending load of group C "bar hammer" locking nail is 14.71% and 14.51% higher than that of common nail, respectively. The results of finite element analysis show that the maximum Von Mises stress and maximum displacement of tibial fracture model and interlocking intramedullary nail model are basically the same as those of tibial fracture model and interlocking intramedullary nail model. The stress distribution is basically similar; However, the maximum Von Mises stress and the maximum displacement of the "bar mallet" locking nail in different positions are obviously lower than those of the common locking nail, and the stress is dispersed to the two ends of the lock nail. Conclusion: the bending strength of "bar hammer" locking nail is higher than that of common lock nail, and the stress is dispersed to both ends of lock nail, and fatigue fracture is not easy to occur, so its mechanical property is superior to that of common lock nail.
【學(xué)位授予單位】：天津理工大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前8條

1 徐耀增;董天華;董啟榕;;葉子交鎖加壓髓內(nèi)針的研制和三種髓內(nèi)針的生物力學(xué)比較[J];骨與關(guān)節(jié)損傷雜志;1993年02期

2 閆宏偉;劉凱;黃向輝;王坤正;宋金輝;張開放;劉軍;;新型脛骨交鎖髓內(nèi)釘對脛骨穩(wěn)定性骨折治療作用的生物力學(xué)研究[J];生物骨科材料與臨床研究;2007年03期

3 王凱;;三維有限元分析在骨科中的應(yīng)用[J];生物骨科材料與臨床研究;2013年01期

4 王一民;黃愛軍;黃醒中;周序玲;曾瑞芬;;跟骨B銉hler角改變對跟骨應(yīng)力影響的有限元分析[J];實(shí)用骨科雜志;2013年05期

5 高慶;王永清;;帶鎖髓內(nèi)釘治療脛骨骨折研究進(jìn)展(綜述)[J];中國城鄉(xiāng)企業(yè)衛(wèi)生;2012年03期

6 李健民,胥少汀,李鐵防,于學(xué)均,劉樹清,鄒德威,趙志棟,陳世杰,姜金衛(wèi);組合式防旋轉(zhuǎn)髓內(nèi)針的研制及臨床應(yīng)用[J];中華骨科雜志;1996年09期

7 王永清,羅先正,劉長貴,郭艾,張保中,鄒愛春;國人股骨脛骨髓腔的形態(tài)學(xué)研究及帶鎖髓內(nèi)釘?shù)母倪M(jìn)[J];中華骨科雜志;1998年04期

8 林松青;王彬;張磊;楊曾靜;;有限元分析在骨科中的應(yīng)用及研究進(jìn)展[J];中國中醫(yī)骨傷科雜志;2013年04期

，

本文編號：2395734