手术预防部分腓骨切除并发症的有限元分析

Feasibility of Different Preventive Operation Techniques Against Complications after Partial Fibulectomy

部分腓骨切除术后 ,预防并发症的手术方法屡有报道 .本研究首次运用计算机有限元模拟技术 ,分析不同预防性术式对下肢骨力学性质的影响 .实验分两部分进行 ,首先测定人新鲜腓骨和 31 7L医用不锈钢的弹性模量 ,然后运用有限元程序软件分别建立各术式下腓骨的有限元模型 ,进行应力计算 ,并经统计学方法处理 .结果显示 :理想的部分腓骨切除术后并发症的预防措施是截骨后就立即恢复腓骨的完整性 ,在避免二次取骨带来的新的损伤、尚无成功的体外培养自体成形骨组织的前提下 ,以不锈钢或钛合金等人工材料代替缺损的腓骨经有限元分析是可行的 ,利于部分或完全消除术后踝关节不稳和疼痛等并发症 .

To avert the commonly reported complications after partial fibulectomy, many preventive operation techniques were proposed. For the first time finite element model was used to analysis the mechanical outcomes in crural bone under different operation conditions. The first part of our experiment is the elastic modulus measurement of human fresh fibular shaft and 317L stainless steel, and in second part, finite element models of fibula under different operational status were set up, stress distribution was calculated and the results were treated with statistical method. We found that the ideal preventive practice is to resume the integrity of fibula right after resection. Because bone autotransplantation would bring further injury, and till now no entire bone tissue such as stainless steel and titanium alloy, which could contribute to the partial or complete prevention of ankle joint unstability and pain after partial fibulectomy.