人体肘关节屈伸稳定性的生物力学研究

发布时间：2018-04-29 11:58

本文选题：稳定性 + 肘关节　；参考：《天津科技大学》2017年硕士论文

【摘要】：近年来,因日常活动、剧烈的体育运动及创伤等导致的肘关节内外侧副韧带、关节囊等损伤所引起的肘关节不稳定的发生明显增加。根据一些临床实验结果发现,大多数人在肘关节损伤恢复之后屈曲运动影响不大,但伸直运动却受到严重阻碍,极大地影响了日常生活和工作。目前对于肘关节韧带及关节囊的损伤机理和修复尚不清楚,因此构建具有高仿真度的成人肘关节有限元模型,研究其在屈伸过程中相关结构的生物力学特性,对减少和防护上肢损伤、维护肘关节功能的稳定有重要的理论意义和实际应用价值。本课题基于正常成人上肢CT扫描数据,应用医学影像处理软件和逆向工程软件,提取上肢几何轮廓,构建具有高仿真度的肘关节有限元模型(包括肱骨、尺骨和桡骨,肱骨远端和尺、桡骨近端关节面软骨,尺侧副韧带前束、后束和斜束以及桡侧副韧带)。对构建的肘关节有限元模型进行有效性验证。并对肘关节进行从中立90°位到0°位的屈伸仿真模拟运算,其分析基于以下两种情况,正常情况:有尺侧副韧带前束、后束和斜束以及桡侧副韧带;损伤情况(韧带部分缺失):(1)有尺侧副韧带后束、斜束以及桡侧副韧带,无前束;(2)有尺侧副韧带前束、斜束以及桡侧副韧带,无后束;(3)有尺侧副韧带前束、后束以及桡侧副韧带,无斜束;(4)有尺侧副韧带前束、后束以及斜束,无桡侧副韧带。将结果与以往的文献资料进行对比分析,验证模型的有效性;研究肘关节从中立90°位到0°位伸直运动的过程中,关节面软骨和相关韧带的应力分布及大小变化情况。对正常肘关节关节面软骨、尺侧副韧带和桡侧副韧带的应力情况进行分析,结果表明:本文构建的肘关节三维有限元模型具有较高的有效性;肘关节从中立90°位到0°位伸直运动的过程中,接触应力最大的部位大都集中在尺骨滑车切迹突处,这与临床上观测大致相符;尺侧副韧带和桡侧副韧带所受应力大都集中于起、止侧部位,且在肘关节伸肘15°之前,桡侧副韧带起主要作用,伸肘角度超过15°之后起主要作用的是尺侧副韧带前束,其次是尺侧副韧带后束,最后是尺侧副韧带斜束。本研究对临床上由关节面软骨磨损严重而导致的关节炎疾病以及韧带的损伤机理、修复和重建有一定的指导意义,为运动医学、临床医学、康复医学等提供理论依据,同时为深入揭示人体肘关节运动规律、运动创伤的预防和康复、人工关节的优化设计以及肘关节稳定性的维持提供理论支持。
[Abstract]:In recent years, the instability of elbow joint caused by injuries such as internal and external collateral ligament, joint capsule and so on caused by daily activities, violent sports and trauma has increased significantly. According to the results of some clinical experiments it is found that most people have little effect on flexion motion after the recovery of elbow joint injury but the straightening movement is seriously hindered which greatly affects daily life and work. At present, the damage mechanism and repair of the ligament and capsule of elbow joint are not clear, so the finite element model of adult elbow joint with high imitation degree is constructed, and the biomechanical characteristics of the related structure during the process of flexion and extension are studied. It has important theoretical significance and practical application value in reducing and protecting upper limb injury and maintaining the function stability of elbow joint. Based on CT scan data of normal adult upper limb, the geometric contour of upper limb was extracted by medical image processing software and reverse engineering software, and the finite element model of elbow joint (including humerus, ulna and radius) was constructed. Distal humerus and ulnar, proximal articular cartilage, anterior bundle of ulnar collateral ligament, posterior bundle and oblique bundle, and radial collateral ligament. The validity of the constructed finite element model of elbow joint is verified. The elbow joint was simulated from neutral 90 掳position to 0 掳position. Its analysis was based on the following two conditions: anterior bundle of ulnar collateral ligament, posterior bundle and oblique bundle and radial collateral ligament; Injury (partial loss of ligamentum: 1) posterior bundle of ulnar collateral ligament, oblique bundle and radial collateral ligament, no anterior bundle of collateral ligament, anterior bundle of ulnar collateral ligament, oblique bundle and radial collateral ligament, no posterior bundle, anterior bundle of ulnar collateral ligament, posterior bundle and radial collateral ligament. There were anterior, posterior and oblique ligaments of ulnar collateral ligament, and no radial collateral ligament. The results were compared with previous literatures to verify the validity of the model, and the stress distribution and size of articular surface cartilage and related ligaments were studied during the extension of elbow joint from neutral 90 掳to 0 掳. The stress of articular surface cartilage, ulnar collateral ligament and radial collateral ligament of normal elbow joint is analyzed. The results show that the three-dimensional finite element model of elbow joint constructed in this paper is highly effective. In the process of elbow joint stretching from neutral 90 掳to 0 掳, most of the contact stress is concentrated at the notch of the ulnar trochlear, which is roughly consistent with the clinical observation, and the stress of the ulnar collateral ligament and radial collateral ligament is mostly concentrated. The radial collateral ligament played the main role before the elbow extension was 15 掳, the anterior bundle of the ulnar collateral ligament, the posterior bundle of the ulnar collateral ligament, and the oblique bundle of the ulnar collateral ligament. This study is of guiding significance for the repair and reconstruction of arthritic diseases and ligament damage caused by severe wear of articular cartilage, and provides theoretical basis for sports medicine, clinical medicine, rehabilitation medicine and so on. At the same time, it provides theoretical support for revealing the movement law of human elbow joint, prevention and rehabilitation of sports trauma, optimization design of artificial joint and maintenance of elbow joint stability.
【学位授予单位】：天津科技大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R68;R318.01

【参考文献】