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尺骨干骺端短缩截骨致桡尺远侧关节接触应力改变的有限元分析

Finite element analysis of contact stress changes in the distal radioulnar joint caused by shortened epiphyseal osteotomy
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摘要 目的通过有限元分析阐明尺骨干骺端短缩截骨后桡尺远侧关节(distal radioulnar joint,DRUJ)接触应力的变化规律。方法以健康男性志愿者为研究对象,获取右上肢在中立位和旋前背伸位时的CT扫描数据,采用Mimics Medical 21.0、Geomagic Design X、Ansys workbench 19.0等软件建立腕关节三维有限元模型。分别模拟尺骨干骺端2、3、4,5mm的短缩截骨,分析非负重和100N轴向应力下DRUJ关节面的最大接触应力,以软骨等效应力云图和数据形式输出。结果中立位DRUJ最大接触应力均位于关节面远端掌侧区域,2~5mm短缩后应力逐渐递增,轴向应力时与非负重状态下应力趋于一致(2.460~5.842 MPa VS 2.152~5.765 MPa);旋前背伸位DRUJ最大接触应力均位于关节面远端近背侧区域,大于中立位,亦随短缩量逐渐递增,轴向应力时高于非负重状态下应力(11.620~24.658 MPa VS 7.652~19.273 MPa)。结论尺骨干骺端短缩截骨后DRUJ的接触应力随短缩量逐渐增加,旋前背伸位的最大接触应力高于中立位,尤其在轴向应力下,而轴向负荷对中立位DRUJ的最大接触应力影响较小。 Objective To investigate the changes in contact stress of the distal radioulnar joint(DRUJ)after osteotomy of the metaphyseal shortening of the ulnar shaft through finite element analysis.Methods A healthy male volunteer was examined by CT scanning of his right upper limb in the neutral and pronation-extension positions respectively,and a three-dimensional finite element model of the wrist joint was established by a series of software,including Mimics Medical 21.0,Geomagic Design X and Ansys workbench 19.0.The simulated shortening osteotomy of 2,3,4 and 5 mm was performed on the ulnar metaphyseal.The contact stress on the DRUJ was analyzed under non-weight-bearing condition and a 100 N longitudinal stress load,and the results were expressed as cartilage equivalent stress nephogram and pressure data.Results In the neutral position,the maximum contact stress on DRUJ was distributed in the distal palmar region of the articular surface and increased gradually after 2 to 5 mm shortening osteotomy.The stress under the longitudinal load was consistent with that under non-load-bearing condition(2.460 to 5.842 MPa VS 2.152 to 5.765 MPa).In pronation-extension position,the maximum contact stress of DRUJ was distributed in the distal proximal dorsal region of the articular surface,which was greater than that in neutral position and gradually increased with the length of shortening osteotomy.The stress under longitudinal load was higher than that under non-weight bearing condition(11.620 to 24.658 MPa VS 7.652 to 19.273 MPa).ConclusionThe contact stress of DRUJ increases gradually with the shortening of the metaphyseal end of the ulna after osteotomy.The maximum contact stress in pronation-extension position is higher than that in the neutral position,especially under axial stress,and the effect of axial load on the maximum contact stress of DRUJ in the neutral position is relatively small.
作者 姜鸿 谭济阳 房小栋 张菲 杨浩钰 刘宇舟 糜菁熠 赵刚 Jiang Hong;Tan Jiyang;Fang Xiaodong;Zhang Fei;Yang Haoyu;Liu Yuzhou;Mi Jingyi;Zhao Gang(Department of Hand Surgery,Wuxi 9th People's Hospital Affliated to Soochow University,Wuxi 214062,China;Department of Sport Medicine,Wuxi 9th People's Hospital Affiliated to Soochow University,Wuxi 214062,China)
出处 《中华手外科杂志》 CSCD 北大核心 2023年第5期431-436,共6页 Chinese Journal of Hand Surgery
基金 江苏省博士后科研资助项目(苏人社函[2020]102号)。
关键词 尺骨 截骨术 桡尺远侧关节 接触应力 有限元分析 Ulna Osteotomy Distal radioulnar joint Contact stress Finite element analysis
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