钳夹加压固定器治疗尺骨鹰嘴骨折的三维有限元分析

The 3-D finite element analysis in the treatment of olecranon fractures with clamp compressing fixer

目的 阐明钳夹加压固定器治疗尺骨鹰嘴骨折的工作原理,科学地指导临床应用。方法 在计算机内进行三维有限元造模,模拟肘关节的生理状态,探讨钳夹加压固定器治疗尺骨鹰嘴骨折的最佳固定方式,最佳固定力和最佳功能锻炼方法。结果 提示钩钳位置应放在尺骨鹰嘴背侧,加压力线离中性轴越远越好;横形骨折的最佳固定力为50 N,斜形、粉碎骨折为25 N;早期练功肌肉收缩力不可过大,肱三头肌肌力要小于70 N,肘关节活动锻炼范围为60°～90°。结论 钳夹加压固定器治疗尺骨鹰嘴骨折,符合骨折治疗的弹性固定准则。

Objective To explain the principle of treating olecranon fractures with clamp compressing fixer and instruct the clinical application Methods The 3-D finite element model was built by computer and the physiological condition of elbow was simulated to discuss the optimum fixing methods, the optimum fixing force and the optimum functional exercise. Results The test showed that the olecranon hook should be placed on the dorsum of the olecranon and the farther the force line was applied away form the neutral axis the better the fixation was. It also showed that the optimum fixing force on transverse fractures was 50 N,oblique fractures and comminuted fractures were 25 N respectively, the muscular contractive force should be moderate when patients were doing early stage functional exercise, the triceps force should be lower than 70 N and the active range of elbow joint should be between 60° and 90°. Conclusion It was in line with the elastic fixation criterion of fractures treatment to treat olecranon fractures with clamp compressing fixer.