点接触锁定接骨板系统的三维有限元分析及生物力学研究
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摘要
目的:
1.探讨点接触锁定接骨板系统和传统动力加压接骨板系统固定股骨干骨折后,接骨板和股骨上的应力、应变分布特征,为进一步生物力学实验和临床应用研究提供理论依据。
2.在骨质疏松性粉碎性骨折模型上,对比研究点接触锁定接骨板系统和传统动力加压接骨板系统的生物力学强度,为进一步动物实验和临床应用研究提供理论依据。
3.建立山羊胫骨粉碎性骨折模型,对比研究点接触锁定加压接骨板与有限接触动力加压接骨板固定骨折后骨痂形成情况,为进一步临床应用研究提供理论依据。
方法:
1.利用计算机辅助设计技术和逆向工程技术,构建接骨板和股骨的三维模型。利用Pro/E软件进行模型装配,模拟接骨板固定骨折的临床实际情况。利用ANSA12.0专业软件进行网格划分,在不同的加载条件下,利用ANSYS10.0软件进行三维有限元分析,得到接骨板和股骨上的应力、应变分布特征。
2.利用双能X线机选取成对的老年性骨质疏松性尸体骨标本,中间横断1cm间隙构建粉碎性骨折模型。在四点弯曲、扭转及轴向压缩加载下,对比研究点接触锁定接骨板系统和传统动力加压接骨板系统的抗弯、抗扭及抗压刚度。
3.选取健康1岁左右山羊,胫骨“Z”字形截骨,建立粉碎性骨折模型, PC-LCP与LC-DCP接骨板固定。通过X线影像学观察、四点弯曲力学测试、组织学观察和计量学研究,对比两种接骨板固定后的骨痂形成情况。
结果:
1.三维有限元分析结果表明,PC-LP系统与LC-DCP系统比较,股骨和接骨板上的应力、应变分布规律大体相同。在轴向压缩和扭转载荷下,从股骨上的螺孔处应力集中现象看,PC-LP接骨板总体上优于LC-DCP接骨板。PC-LP系统在四点前后弯曲、轴向压缩和扭转三种载荷下,接骨板上应力集中的区域位于板边缘或者中间,而股骨的应力都集中在骨折位点最近的两个螺孔或最远的两个螺孔处。
2.在骨质疏松性粉碎性桡骨骨折模型上,PC-LCP与DCP接骨板对比,在前后四点弯曲、内外四点弯曲及扭转实验测试下,PC-LCP固定桡骨骨折模型的抗弯刚度及抗扭刚度均有大于DCP的趋势;而PC-LP与LC-DCP对比时,在前后四点弯曲、内外四点弯曲及扭转实验测试下,PC-LCP固定桡骨骨折模型的抗弯刚度及抗扭刚度均明显大于DCP接骨板,两者差异具有统计学意义。在骨质疏松性粉碎性股骨干骨折模型上,PC-LCP与DCP接骨板对比,在前后四点弯曲、轴向压缩实验测试下,PC-LCP固定股骨干骨折模型的抗弯刚度及抗压刚度均大于DCP接骨板,两者差异具有统计学意义;在扭转实验测试下,PC-LCP固定股骨干骨折模型的抗扭刚度有大于DCP的趋势,但两者差异没有统计学意义。
3.在动物实验中,X线影像学观察,术后8周、术后12周时,PC-LCP组粉碎性骨折处的骨痂形成多于DCP组。术后12周,四点弯曲力学测试,PC-LCP组的骨折愈合后骨痂的弯曲强度和最大载荷均明显大于DCP组,两者差异有统计学意义。术后12周时骨痂组织形态学分析,普通光学显微镜下,PC-LCP组比DCP组的骨小粱形成较多,排列更规则。对于骨痂组织的静态参数,小粱骨痂体积密度(TBV),显微镜下的形态计量学结果提示,PC-LCP组的TBV明显大于DCP组,两者差异具有统计学意义。对于骨痂组织动态参数,骨沉积率(AR),我们采用四环素和钙黄绿素双标,荧光显微镜下观察,形态计量学分析。结果提示,PC-LCP组的骨沉积率平均值大于DCP组,但是两者差异没有统计学意义。两个骨痂的形态学计量结果提示,PC-LCP组比DCP组的骨折愈合更好的机制,可能在于成骨细胞的增殖分化,而不在于骨矿化沉积。
结论:
综上所述,点接触锁定接骨板系统作为一种生物学内固定理念的接骨板,其生物力学特性明显优于传统接骨板,同时其点接触设计,保护了骨折局部血运,促进骨折愈合。对于骨质疏松性和粉碎性骨折,点接触锁定接骨板系统比传统动力加压接骨板系统具有更加优越的生物力学特性,更多骨痂形成,是一种更加理想的生物学接骨板。
Objective:
1.To investigate the distribution of stress and strain on the plate and the femur, we used the finite element analysis method to analyze biomechanic characters of the femoral shaft fracture fixed with the point contact locking plate system (PC-LP) or the limited contact dynamic compression plate system (LC-DCP) under different loading models.
2. To compare biomechanic characters of the point contact locking plate system and the conventional dynamic compression plate system, we used the osteoporotic and comminuted fracture model to test the bending and torsion stiffness under different loading models.
3. To compare the formation of calluses, we established the comminuted tibial fracture model of goats fixed with the point contact locking compression plate system (PC-LCP) or the limited contact dynamic compression plate system.
Methods:
1. The compute aided design technology and the reverse engineering technology were used to establish the three dimension models of plate and femur. After model assembles using the Pro/E software, we used the ANSA12.0 software to generate meshes. Under different loading models, we analyzed the distribution of stress and strain on the plate and the femur using the ANSYS10.0 software.
2. The osteoporotic cadaveric bone was selected by the double energy X-ray machine. A 10 mm gap osteotomy model was used to simulate a comminuted fracture. Under four point bending, torsion and axial compression loading, we compared the bending stiffness, torsion stiffness and compression stiffness of the point contact locking plate system with the conventional dynamic compression plate system.
3. We selected healthy mature goats and made a Z-shape osteotomy fixed with the point contact locking compression plate or the limited contact dynamic compression plate to simulate the comminuted fracture model. Through the X-ray examination, four point bending test and bone morphology study, the calluses formation of the fracture fixed with the point contact locking compression plate was compared with the limited contact dynamic compression plate.
Results:
1. The results of finite element analysis show that the distribution pattens of strain and stress have no significant difference between the point contact locking plate system and the limited contact dynamic compression plate. Under the axial compression and torsion loading, the stress concentration on femur screw holes of PC-LP was less than that of the LC-DCP. Under different loading models, the stress concentration on plate of the PC-LP focus on the middle of the plate or on the edge of the plate. And the stress concentration on femur screw holes of the PC-LP system focus on the middle or the distal two holes
2. The osteoporotic and comminuted radial fracture was made and fixed with the PC-LCP or the DCP. Under anteroposterior four point bending, mediolateral four point bending or torsion test, the average bending stiffness or the average torsion stiffness of the radial fracture model fixed with the PC-LCP have a trend to be more than that of the radial fracture model fixed with the DCP. When the radial fracture model fixed with the PC-LP or the LC-DCP, the average bending stiffness or the average torsion stiffness of the radial fracture model fixed with the PC-LP was significant more than that of the radial fracture model fixed with the LC-DCP. When the femoral fracture model was used and fixed with the PC-LCP or the DCP, we carried out the anteroposterior four point bending, axial compression and torsion test. The average bending stiffness or the average compression stiffness of the femoral fracture model fixed with the PC-LCP was significant more than that of the femoral fracture model fixed with the DCP. And the average torsion stiffness of the PC-LCP has a trend to be more than that of the DCP.
3. In the animal study, the calluses formation of the comminuted fracture fixed with the PC-LCP after the postoperative eight weeks or twelve weeks was more than that of the DCP through the radiographic results. After the postoperative twelve weeks, the average bending strenghth or the average maximum load of the tibia after removing the PC-LCP was significant more than that of the tibia after removing the DCP. After the postoperative twelve weeks, trabecular bone of PC-LCP group was more than that of the DCP group through the morphology study of calluses. Using the histomorphometry of bone, the trabecular bone volume of the PC-LCP group was significant more than that of the DCP group. But the difference of the appositional rate between the PC-LCP group and the DCP group has no significance.
Conclusions:
In summary, as one kind of biological internal fixation, the biomechanic property of the point contact locking plate system is significant higher than that of the conventional dynamic compression plate. At the same time, the poin contact design reduce the vascular damage around the fracture site. Thus, when we manage the osteoporotic and comminuted fracture, the point contact locking plate system is superior to the conventional dynamic compression plate and promote the calluses formation. Compared with the the conventional dynamic compression plate, the point contact locking plate system is one more ideal biological plate.
1.探讨点接触锁定接骨板系统和传统动力加压接骨板系统固定股骨干骨折后,接骨板和股骨上的应力、应变分布特征,为进一步生物力学实验和临床应用研究提供理论依据。
2.在骨质疏松性粉碎性骨折模型上,对比研究点接触锁定接骨板系统和传统动力加压接骨板系统的生物力学强度,为进一步动物实验和临床应用研究提供理论依据。
3.建立山羊胫骨粉碎性骨折模型,对比研究点接触锁定加压接骨板与有限接触动力加压接骨板固定骨折后骨痂形成情况,为进一步临床应用研究提供理论依据。
方法:
1.利用计算机辅助设计技术和逆向工程技术,构建接骨板和股骨的三维模型。利用Pro/E软件进行模型装配,模拟接骨板固定骨折的临床实际情况。利用ANSA12.0专业软件进行网格划分,在不同的加载条件下,利用ANSYS10.0软件进行三维有限元分析,得到接骨板和股骨上的应力、应变分布特征。
2.利用双能X线机选取成对的老年性骨质疏松性尸体骨标本,中间横断1cm间隙构建粉碎性骨折模型。在四点弯曲、扭转及轴向压缩加载下,对比研究点接触锁定接骨板系统和传统动力加压接骨板系统的抗弯、抗扭及抗压刚度。
3.选取健康1岁左右山羊,胫骨“Z”字形截骨,建立粉碎性骨折模型, PC-LCP与LC-DCP接骨板固定。通过X线影像学观察、四点弯曲力学测试、组织学观察和计量学研究,对比两种接骨板固定后的骨痂形成情况。
结果:
1.三维有限元分析结果表明,PC-LP系统与LC-DCP系统比较,股骨和接骨板上的应力、应变分布规律大体相同。在轴向压缩和扭转载荷下,从股骨上的螺孔处应力集中现象看,PC-LP接骨板总体上优于LC-DCP接骨板。PC-LP系统在四点前后弯曲、轴向压缩和扭转三种载荷下,接骨板上应力集中的区域位于板边缘或者中间,而股骨的应力都集中在骨折位点最近的两个螺孔或最远的两个螺孔处。
2.在骨质疏松性粉碎性桡骨骨折模型上,PC-LCP与DCP接骨板对比,在前后四点弯曲、内外四点弯曲及扭转实验测试下,PC-LCP固定桡骨骨折模型的抗弯刚度及抗扭刚度均有大于DCP的趋势;而PC-LP与LC-DCP对比时,在前后四点弯曲、内外四点弯曲及扭转实验测试下,PC-LCP固定桡骨骨折模型的抗弯刚度及抗扭刚度均明显大于DCP接骨板,两者差异具有统计学意义。在骨质疏松性粉碎性股骨干骨折模型上,PC-LCP与DCP接骨板对比,在前后四点弯曲、轴向压缩实验测试下,PC-LCP固定股骨干骨折模型的抗弯刚度及抗压刚度均大于DCP接骨板,两者差异具有统计学意义;在扭转实验测试下,PC-LCP固定股骨干骨折模型的抗扭刚度有大于DCP的趋势,但两者差异没有统计学意义。
3.在动物实验中,X线影像学观察,术后8周、术后12周时,PC-LCP组粉碎性骨折处的骨痂形成多于DCP组。术后12周,四点弯曲力学测试,PC-LCP组的骨折愈合后骨痂的弯曲强度和最大载荷均明显大于DCP组,两者差异有统计学意义。术后12周时骨痂组织形态学分析,普通光学显微镜下,PC-LCP组比DCP组的骨小粱形成较多,排列更规则。对于骨痂组织的静态参数,小粱骨痂体积密度(TBV),显微镜下的形态计量学结果提示,PC-LCP组的TBV明显大于DCP组,两者差异具有统计学意义。对于骨痂组织动态参数,骨沉积率(AR),我们采用四环素和钙黄绿素双标,荧光显微镜下观察,形态计量学分析。结果提示,PC-LCP组的骨沉积率平均值大于DCP组,但是两者差异没有统计学意义。两个骨痂的形态学计量结果提示,PC-LCP组比DCP组的骨折愈合更好的机制,可能在于成骨细胞的增殖分化,而不在于骨矿化沉积。
结论:
综上所述,点接触锁定接骨板系统作为一种生物学内固定理念的接骨板,其生物力学特性明显优于传统接骨板,同时其点接触设计,保护了骨折局部血运,促进骨折愈合。对于骨质疏松性和粉碎性骨折,点接触锁定接骨板系统比传统动力加压接骨板系统具有更加优越的生物力学特性,更多骨痂形成,是一种更加理想的生物学接骨板。
Objective:
1.To investigate the distribution of stress and strain on the plate and the femur, we used the finite element analysis method to analyze biomechanic characters of the femoral shaft fracture fixed with the point contact locking plate system (PC-LP) or the limited contact dynamic compression plate system (LC-DCP) under different loading models.
2. To compare biomechanic characters of the point contact locking plate system and the conventional dynamic compression plate system, we used the osteoporotic and comminuted fracture model to test the bending and torsion stiffness under different loading models.
3. To compare the formation of calluses, we established the comminuted tibial fracture model of goats fixed with the point contact locking compression plate system (PC-LCP) or the limited contact dynamic compression plate system.
Methods:
1. The compute aided design technology and the reverse engineering technology were used to establish the three dimension models of plate and femur. After model assembles using the Pro/E software, we used the ANSA12.0 software to generate meshes. Under different loading models, we analyzed the distribution of stress and strain on the plate and the femur using the ANSYS10.0 software.
2. The osteoporotic cadaveric bone was selected by the double energy X-ray machine. A 10 mm gap osteotomy model was used to simulate a comminuted fracture. Under four point bending, torsion and axial compression loading, we compared the bending stiffness, torsion stiffness and compression stiffness of the point contact locking plate system with the conventional dynamic compression plate system.
3. We selected healthy mature goats and made a Z-shape osteotomy fixed with the point contact locking compression plate or the limited contact dynamic compression plate to simulate the comminuted fracture model. Through the X-ray examination, four point bending test and bone morphology study, the calluses formation of the fracture fixed with the point contact locking compression plate was compared with the limited contact dynamic compression plate.
Results:
1. The results of finite element analysis show that the distribution pattens of strain and stress have no significant difference between the point contact locking plate system and the limited contact dynamic compression plate. Under the axial compression and torsion loading, the stress concentration on femur screw holes of PC-LP was less than that of the LC-DCP. Under different loading models, the stress concentration on plate of the PC-LP focus on the middle of the plate or on the edge of the plate. And the stress concentration on femur screw holes of the PC-LP system focus on the middle or the distal two holes
2. The osteoporotic and comminuted radial fracture was made and fixed with the PC-LCP or the DCP. Under anteroposterior four point bending, mediolateral four point bending or torsion test, the average bending stiffness or the average torsion stiffness of the radial fracture model fixed with the PC-LCP have a trend to be more than that of the radial fracture model fixed with the DCP. When the radial fracture model fixed with the PC-LP or the LC-DCP, the average bending stiffness or the average torsion stiffness of the radial fracture model fixed with the PC-LP was significant more than that of the radial fracture model fixed with the LC-DCP. When the femoral fracture model was used and fixed with the PC-LCP or the DCP, we carried out the anteroposterior four point bending, axial compression and torsion test. The average bending stiffness or the average compression stiffness of the femoral fracture model fixed with the PC-LCP was significant more than that of the femoral fracture model fixed with the DCP. And the average torsion stiffness of the PC-LCP has a trend to be more than that of the DCP.
3. In the animal study, the calluses formation of the comminuted fracture fixed with the PC-LCP after the postoperative eight weeks or twelve weeks was more than that of the DCP through the radiographic results. After the postoperative twelve weeks, the average bending strenghth or the average maximum load of the tibia after removing the PC-LCP was significant more than that of the tibia after removing the DCP. After the postoperative twelve weeks, trabecular bone of PC-LCP group was more than that of the DCP group through the morphology study of calluses. Using the histomorphometry of bone, the trabecular bone volume of the PC-LCP group was significant more than that of the DCP group. But the difference of the appositional rate between the PC-LCP group and the DCP group has no significance.
Conclusions:
In summary, as one kind of biological internal fixation, the biomechanic property of the point contact locking plate system is significant higher than that of the conventional dynamic compression plate. At the same time, the poin contact design reduce the vascular damage around the fracture site. Thus, when we manage the osteoporotic and comminuted fracture, the point contact locking plate system is superior to the conventional dynamic compression plate and promote the calluses formation. Compared with the the conventional dynamic compression plate, the point contact locking plate system is one more ideal biological plate.
引文
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