儿童与成人桡骨远端屈曲型骨折产生机制的比较研究

Comparative study on the difference of mechanism causing flexion-type fracture of distal radius between in children and adults

目的:用平面有限元法及生物力学原理对儿童与成人桡骨远端屈曲型骨折裂纹走向及移位过程进行定量研究,比较两者产生机制的不同之处,以指导临床诊治。方法:收集儿童及成人桡骨的X线片,分别建立儿童与成人桡骨远端屈曲型骨折的模型,用有限元法计算桡骨中各点的应力分布。在骨折即将发生的瞬间,将桡骨隔离,对其进行受力分析,依据生物力学原理分析比较两者骨折裂纹走向及移位和复位过程的区别。结果:桡骨远端屈曲型骨折的裂纹走向:儿童由掌远斜向背近,成人由背远斜向掌近。生物力学研究结果表明,桡骨远端屈曲型骨折复位过程是:儿童以拔伸回旋手法为主,成人以拔伸折顶手法为主。结论:对于儿童桡骨远端屈曲型骨折压垫应置于远折端的背桡侧及近折端的掌侧,对成人压垫应置于远折端的掌桡侧及近折端的背侧。

Objective： To design quantitative study on the fracture line and the process of displacement of flexion-type fracture of distal radius occurred in children and adults by using finite element and biomeehanies methods, to compare the differenees of mechanism of the two type fractures in children and adults, so as to guide clinical treatment, Methods ： The X-rays of radius in children and adults were collected, At first, the models of children＇s and adult＇s flexion-type fracture of distal radius were established respectively in computer. Then the stress analysis at every point of the radial was calculated using finite-element method, At last the differences in the fracture line, the process of displacement and reduction between the two models were analyzed based on biomechanical principle, Results： The fracture line of the flexion-type fracture of distal radial was as follows ： The children＇s fracture line moved from the distant point of volar to the near point of the back slantingly,while that of the aduhs＇was from the distant point of the back to the near point of volar slantingly, The process of reduction was that traction and convolution could be mainly applied to children＇s,while the traction and pushing mainly to adults, Conclusion： As far as flexion-type fracture of distal radial is concerned, pressure pad for children should be placed at the back radial surface of the distal end and the volar of the proximal end, while for adults pressure pad should be placed at the volar radial surface of the distal end and the back of the proximal end.