新型可调式跟骨骨折外固定支架的设计研究

发布时间：2018-03-29 10:41

  本文选题：跟骨骨折　切入点：跟骨解剖参数　出处：《南方医科大学》2017年硕士论文

【摘要】：目的:分析成人正常跟骨解剖参数及跟骨骨折影像学资料,设计一款微型、可调节的跟骨骨折外固定支架,并通过有限元分析法验证其可行性。方法:1、收集跟骨骨折影像学结果,分析、归纳跟骨骨折类型,为跟骨骨折的治疗方式提供参考依据。连续性纳入自2012年10月至2016年12月在我院收治的跟骨骨折患者共计347例(382足),均做X线及CT检查确诊。由三名高年资骨科医师对患者影像学资料进行分型评价及选择治疗方式。2、获取成人正常跟骨X线片及CT扫描图像,利用Mimics 15.0软件测量成人正常跟骨的解剖参数,为新型跟骨外固定支架的设计提供参考数据。收集40例(男性20例,女性20例)成人正常跟骨CT扫描图像,将图像数据导入Mimics 15.0软件,三维重建后测量跟骨长度、宽度、高度等参数,通过公式计算跟骨各部位骨密度值,划定骨密度较高区域为可靠进针点,依据上述解剖参数设计出新型可调式跟骨外固定支架。3、通过有限元分析法建立跟骨Sanders Ⅱ、Ⅲ型骨折术后有限元模型,加载压应力,分析该模型的稳定性及应力分布情况:征集成年男性志愿者一名,获取该男子足踝部CT扫描图像,依据新型外固定支架设计图,通过计算机软件建立Sanders Ⅱ、Ⅲ型跟骨骨折术后有限元模型,加载应力,记录骨折块位移,分析其应力分布情况。结果:1、最终纳入病例共计337足,依据CT Sanders分型:Ⅰ型78足(23.15%),Ⅱ型 167 足(49.55%)、Ⅲ型 61 例(18.10%)、Ⅳ型 31 足(9.20%)。259 足(76.85%)需要手术干预。2、男性组跟骨全长、宽度及高度分别为(74.52±5.01)、(29.56±2.94)、(44.21±4.26)mm;女性组分别为(71.28±5.25)、(26.85±3.21)、(40.16±4.38)mm,以上项目两组间比较差异均具有统计学意义(P0.05)。经计算,跟骨前部、结节部、丘部、载距突处骨质较密,为可靠进针点。3、模型加载载荷后,新型外固定支架治疗跟骨Sanders Ⅱ和Sanders Ⅲ型骨折的两种模型总体位移峰值分别为:0.2483mm,0.2747mm,应力峰值为:110.3MPa,125.4MPa;两种模型支架钢钉位移峰值分别为:0.1504mm,0.1736mm,应力峰值为:110.3MPa,125.4MPa;两种模型跟骨位移峰值分别为:0.2483mm,0.2747mm,应力峰值为:40.33MPa,38.13MPa。结论:1、建立的跟骨三维模型骨折形态清晰、符合实验要求,所测得相关跟骨解剖参数精确、可靠,为外固定支架的设计提供有效参考。2、新型可调式跟骨外固定支架均能为跟骨Sanders Ⅱ、Ⅲ型骨折提供足够的生物力学稳定性,足踝部各骨块应力分布较为合理,外固定支架克式针存在应力集中,在理想范围之内。应用该外固定支架固定Sanders Ⅱ型骨折时位移峰值及应力峰值更小,该外固定支架更适用于跟骨Sanders Ⅱ型骨折。
[Abstract]:Objective: to analyze the anatomical parameters of normal calcaneus and the imaging data of calcaneal fracture in adults, and to design a miniature, adjustable external fixator for calcaneal fracture. The feasibility was verified by finite element analysis. Methods: 1. The imaging results of calcaneal fractures were collected, and the types of calcaneal fractures were summarized. From October 2012 to December 2016, 347 patients with calcaneal fracture were admitted in our hospital. All patients were diagnosed by X-ray and CT. In order to obtain the normal calcaneal X-ray and CT scan images of adult calcaneal bone, the physician evaluated the imaging data of the patients and selected the treatment method. The anatomical parameters of normal calcaneus in adults were measured by Mimics 15.0 software to provide reference data for the design of new external fixation scaffolds of calcaneus. Ct scanning images of normal calcaneus were collected in 40 adults (20 males and 20 females). The image data were imported into Mimics 15.0 software. The length, width and height of calcaneus were measured after 3D reconstruction. The bone mineral density of various parts of calcaneus was calculated by formula. According to the above anatomical parameters, a new adjustable calcaneal external fixator was designed. The finite element model of calcaneal Sanders 鈪，

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