三种空心钉构型踝关节融合的有限元分析
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张宁,主治医师,研究方向:足踝关节,(电话)13626343117,(电子信箱)zhangmishu@163.com

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R683.42

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A finite element analysis on ankle joint fusion with three cannulated screw configurations
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    摘要:

    [目的] 通过有限元分析,研究空心钉不同构型对镜下踝关节融合稳定性的影响。[方法] 选择1 例37 岁男性志愿者为研究对象,螺旋CT 自膝关节至足底进行薄层扫描,获得DICOM 图像导入到Mimics 中分割跟骨、距骨、胫骨、腓骨三维点云,Geomagic、Hypermesh 中模拟构建踝关节有限元模型,分别建立正常对照模型和双钉平行、双钉交叉和三钉交叉的踝关节融合模型。观察模型中胫距关节面相对位移、Mises 应力峰值及平均Mises 应力。[结果] 载荷下双钉平行组位移显著大于双钉交叉组和三钉交叉组,包括跖屈[(106.2±8.6) μm vs (58.9±4.5) μm vs (58.5±4.1) μm, P<0.001],内旋[(101.6±6.4) μm vs (59.1±4.4) μm vs (58.5±4.0) μm, P<0.001] 和外旋[(101.5±6.6) μm vs (58.5±4.6) μm vs (58.3±4.2) μm, P<0.001],而双钉交叉组和三钉交叉组之间差异无统计学意义(P>0.05)。双钉平行组空心钉的应力峰值大于双钉交叉组和三钉交叉组,其中站立状态下(65.5MPa , 51.3 MPa, 50.5 MPa),双钉平行组胫距关节平均Mises 应力显著小于双钉交叉组、三钉交叉组(P<0.05),双钉交叉组、三钉交叉组之间差异无统计学意义(P>0.05)。[结论] 双钉交叉组、三钉交叉组空心钉构型的稳定性优于双钉平行组,有利于提高镜下踝关节融合的成功率。

    Abstract:

    [Objective] To explore the effect of different configurations of cannulated screws on the stability of ankle joint fusion by fi-nite element analysis. [Methods] Thin-layer scan from knee joint to sole was performed in a 37-year-old male volunteer by spiral CT, andDICOM images were obtained and imported into Mimics to segment three-dimensional point clouds of calcaneus, talus, tibia and fibula,and then, the finite element model of ankle joint was simulated in Geomagic and Hypermesh. The normal control model and the ankle jointfusion models with double screws parallel (DSP), double screws crossover (DSC) and triple screws crossover (TSC) were established respec-tively. The relative displacement of the tibial talar joint surface, the Mises stress peak value and the mean Mises stress in the model were ob-served. [Results] The DSP group proved significantly greater than the DSC and TSC groups in term of displacements under loading, includ-ing plantar flexion [(106.2±8.6) μm vs (58.9±4.5) μm vs (58.5±4.1) μm, P<0.001] internal rotation [(101.6±6.4) μm vs (59.1±4.4) μm vs(58.5±4.0) μm, P<0.001] and external rotation [(101.5±6.6) μm vs (58.5±4.6) μm vs (58.3±4.2) μm, P<0.001], while there was no signifi-cant difference between the DSC and TSC groups (P>0.05). The DSP had significantly greater peaks Mises stress on the implant than DSCgroup and the TSC group (65.5 MPa, 51.3 MPa, 50.5 MPa). In addition, the Mises stress on the tibiotalar articular surface in the DSP groupwas significantly less than those in the DSC and the TSC groups (P<0.05), whereas which was not statistically significant between DSCgroup and TSC group (P>0.05). [Conclusion] The DSC and TSC have significantly better stability of the screw placement configuration thanthat in DCP placement, while good stability of the screw palcement is conducive to improving the success rate of arthroscopic ankle arthrod-esis.

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张宁,康颂科,李伟延,等. 三种空心钉构型踝关节融合的有限元分析[J]. 中国矫形外科杂志, 2024, (8): 744-749. DOI:10.3977/j. issn.1005-8478.2024.08.13.
ZHANG Ning, KANG Song-ke, LIWei-yan, et al. A finite element analysis on ankle joint fusion with three cannulated screw configurations[J]. ORTHOPEDIC JOURNAL OF CHINA , 2024, (8): 744-749. DOI:10.3977/j. issn.1005-8478.2024.08.13.

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  • 收稿日期:2023-01-10
  • 最后修改日期:2023-12-04
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  • 在线发布日期: 2024-04-22
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