前置远端单螺钉钢板治疗NeerⅡ型锁骨远端骨折的有限元分析

Finite Element Analysis of Anterior Plate With Distal Single Screw in the Treatment of NeerⅡDistal Clavicle Fracture

目的:探讨前置远端单螺钉钢板系统治疗NeerⅡ型锁骨远端骨折的生物力学特点。方法:通过CT扫描获得一男性成年志愿者的锁骨,使用Solidworks、Mimics19.0软件处理获得前置远端单螺钉钢板及解剖锁定钢板两组锁骨钢板模型,后用ANSYS17软件进行网格划分,加载并记录分析两种固定方式在轴向压缩、三点弯曲、扭矩旋转的加载条件下的骨折位移和最大应力。结果:在轴向压缩载荷下,两组模型的整体最大等效应力及整体骨折最大位移无显著差异(P>0.05);在三点弯曲载荷下,两组模型整体最大等效应力无统计学差异(P>0.05),整体骨折最大位移有统计学差异(P<0.05);在顺时针扭矩载荷下,两组模型整体最大等效应力及整体骨折最大位移无统计学差异(P>0.05);在逆时针扭矩载荷下,两组模型最大应力有统计学差异(P<0.05),整体骨折最大位移无统计学差异(P>0.05)。结论:前置远端单螺钉钢板系统在模拟肩关节活动的情况下,比解剖锁定钢板更易发生应力集中的现象,但两组钢板模型都能提供坚强的内固定,前置远端单螺钉钢板可以为治疗复杂特殊的NeerⅡ锁骨远端骨折提供思路。

Objective:To investigate the biomechanical characteristics of anterior plate with distal single screw system in the treatment of NeerⅡdistal clavicle fracture.Methods:The clavicle of an adult male volunteer was obtained by CT scanning.Solidworks and Mimics19.0 software were used to obtain two sets of clavicle plate models:anterior plate with distal single screw and anatomical locking plate,and then ANSYS17 software was used to mesh.The maximun fracture displacement and maximum stress of the two fixation methods under axial compression,three-point bending and torque rotation were loaded and recorded.Results:Under axial compression load,there were no significant differences in the maximum stress and maximum fracture displacement between the two groups(P>0.05).Under three-point bending load,the maximum stress of the two groups had no significant difference(P>0.05),and the maximum fracture displacement had significant difference(P<0.05).Under the clockwise torque loading,the maximum stress and maximum fracture displacement of the two groups were not significantly different(P>0.05).Under counterclockwise torque loading,there were significant differences in maximum stress between the two groups(P<0.05),and the maximum fracture displacement were not significant difference(P>0.05).Conclusion:The anterior plate with distal single screw system is more prone to stress concentration than the anatomic locking plate when the shoulder joint is simulated.However,both sets of plate models can provide a strong internal fixation.This plate can provide a new idea for the treatment of some complex and special NeerⅡdistal clavicle fractures.