坐位下骨盆T型骨折的三维有限元分析

Three-dimensional Finite Element Analysis to T-shaped Fracture of Pelvis in Sitting Position

本文创建了考虑韧带影响的完整三维骨盆模型,按Letournel分型,构建了骨盆T型骨折以及临床复位常用的三种内固定模型:双柱钛板、前路钛板联合后柱螺钉和前路钛板加方形区螺钉。在验证骨盆模型的有效性基础上,发现该模型能够较为准确地反映骨盆在真实状态下的力学行为。三种内固定方式对T型骨折均有较好的复位效果。所有内固定系统均可以增加模型刚度、减弱应力集中以及减弱骨折线位移差。由于四方区螺钉进钉位置均位于皮质骨中,对骨折具有良好的固定效果,因此,第三种内固定(前路钛板加方形区螺钉)对于T型骨折固定效果最好。

We developed a three-dimensional finite element model of the pelvis. According to Letournel methods, we established a pelvis model of T-shaped fracture with its three different fixation systems, i.e. double column recon- struction plates, anterior column plate comhined with posterior column screws and anterior column plate combined with quadrilateral area screws. It was found that the pelvic model was effective and could be used to simulate the me- chanical behavior of the pelvis. Three fixation systems had great therapeutic effect on the T-shaped fracture. All fix- ation systems could increase the stiffness of the model, decrease the stress concentration level and decrease the dis- placement difference along the fracture line. The quadrilateral area screws, which were drilled into cortical bone, could generate beneficial effect on the T-type fracture. Therefore, the third fixation system mentioned above （i. e. the anterior column plate combined with quadrilateral area screws） has the best biomeehanical stability to the T-type fracture.