DAPSQ治疗前柱伴后半横行髋臼骨折力学稳定性的有限元分析

发布时间：2018-07-29 08:29

【摘要】：目的:利用有限元方法研究动力化前路方形区钛板螺钉系统(DAPSQ)治疗前柱伴后半横行髋臼骨折的生物力学稳定性及合并对侧耻骨上下支骨折对其生物力学稳定性的影响,以期为临床上应用提供生物力学指导。方法:(1)选取一名健康成年男性志愿者(排除各种骨盆病变及畸形),予以知情同意,采用16排螺旋CT机对其第四腰椎至股骨上段进行0.5mm薄层平扫,获得全骨盆体层图像数据并以Dicom格式保存,将数据导入有限元处理软件Mimics10.01,进行骨盆三维几何模型重建,再利用Ansys软件下处理网格的模块软件ICEM对骨盆三维重建模型进行六面体网格划分。再运用Hypermesh V10.0软件调整网格质量,在此基础上根据解剖结构加载韧带,初步建立骨盆三维六面体单元有限元模型,将数据导入有限元软件ABAQUS 6.12进行骨盆应力计算分析。模拟坐位骨盆受力,将得到的应力云图与体外实验及其它模型文献数据进行有效性对比验证。(2)运用有限元分析方法构建右侧高位前柱伴后半横行髋臼骨折的全骨盆模型,对右侧髋臼骨折分别采用DAPSQ(A),前路重建钛板联合后柱拉力螺钉(B),双柱钛板内固定(C)固定。将建好的有限元模型导入ABAQUS6.12软件,模拟坐位加载600N生理载荷,比较各组骨折端的位移及应力分布情况,分析3种不同内固定方式在固定前柱伴后半横行髋臼骨折的生物力学稳定性;(3)根据已验证DAPSQ固定前柱伴后半横行髋臼骨折的稳定的情况下,分别构建出三组内固定模型:对侧骨盆环完整(A)、对侧耻骨上下支骨折内固定(B)及对侧耻骨上下支骨折未固定(C),模拟坐位加载600N生理载荷,比较各组右侧骨折端的位移及应力分布情况,分析在3种不同情况下DAPSQ固定前柱伴后半横行髋臼骨折的生物力学稳定性。结果:(1)本研究建立了具有详细解剖结构的全骨盆三维非线性六面体有限元模型,本模型共包含有限元单元格86444个,节点88388个,经比较,本模型所生理载荷下受到的应力分布与体外实验及其它文献模型数据相符合。(2)在模拟坐位加载600N生理载荷时3种内固定模型髋臼臼顶的纵向位移及后柱内壁的横向位移分布表现为CBA,坐位下A、B、C三组内固定模型臼顶纵向位移分别为(0.959±0.216)、(0.970±0.220)、(0.978±0.223)mm,后柱内壁横向位移分别为(0.903±0.034)、(0.930±0.045)、(0.997±0.068)mm,三种内固定模型所受应力表现为CBA,C与A、B的差异均具有明显统计学意义(P0.05)。(3)在对侧骨盆环是否稳定的3种情况下的内固定模型中,A、B、C三组内固定模型臼顶纵向位移差异无显著意义;后柱内壁横向位移分别为(0.903±0.034)、(0.910±0.038)、(1.117±0.380)mm,DASPQ方形区处螺钉所受应力表现为ABC,差异有统计学意义。结论:(1)本研究建立了一个具有较高仿真性的正常人体全骨盆三维非线性六面体有限元模型,该模型构建了基本的骨盆韧带组织,解剖结构完整,使得模型能够基本符合骨盆的真实情况,通过对其进行相应的有效性验证,得出该模型可用来进行与临床相关的生物力学研究。(2)DAPSQ治疗前柱伴后半横行髋臼骨折具有良好的生物力学稳定性。(3)DASPQ固定前柱伴后半横行髋臼骨折时,在对侧骨盆环稳定的前提下可以提供较好的生物力学稳定性。
[Abstract]:Objective: To study the biomechanical stability of the anterior column of titanium plate screw system (DAPSQ) in the treatment of anterior column with posterior semi transverse acetabular fracture with the finite element method and the effect of the combined upper and lower branch fracture of the pubic symphysis on its biomechanical stability in order to provide a biomechanical guidance for clinical application. Method: (1) select a healthy adult. The male volunteers (excluding the various pelvic lesions and deformities) were given informed consent. The 16 row spiral CT was used to scan the fourth lumbar vertebrae to the upper femur by 0.5mm thin layer scanning. The data of the whole pelvic body layer were obtained and stored in the Dicom format. The data were introduced into the finite element treatment Mimics10.01, and the three-dimensional geometric model of the pelvis was rebuilt. Using the module software ICEM to deal with the grid in Ansys software, the three-dimensional reconstruction model of the pelvis is divided into hexahedral mesh. Then the Hypermesh V10.0 software is used to adjust the quality of the grid. On this basis, the ligaments are loaded according to the anatomical structure, and the finite element model of the three-dimensional hexahedral element in the pelvis is preliminarily established, and the data are introduced into the finite element software ABAQUS 6.12. The pelvic stress was analyzed. The stress of the sitting pelvis was simulated, and the effectiveness of the stress cloud map was compared with the other model literature data. (2) the whole pelvis model of the right high position anterior column with the posterior half transverse acetabular fracture was constructed by the finite element analysis method, and DAPSQ (A) was used for the right acetabular fracture, and the anterior approach was used. The titanium plate combined with posterior column pull screw (B) and double column titanium plate internal fixation (C) were fixed. The established finite element model was introduced into ABAQUS6.12 software to simulate the physiological load of loading 600N at the seat position, to compare the displacement and stress distribution of the fracture ends of each group, and to analyze the biomechanical stability of 3 different internal fixation methods in the anterior column with the posterior half transverse acetabular fracture. (3) three groups of internal fixation models were constructed on the basis of the stability of DAPSQ fixed anterior column with posterior half transverse acetabular fracture: contralateral pelvic ring integrity (A), contralateral suprapubic fracture internal fixation (B) and contralateral suprapubic fracture (C), simulated sitting position loading 600N physiological load, and comparing the right fracture ends of each group. The biomechanical stability of DAPSQ fixed anterior column with posterior half transverse acetabular fracture was analyzed in 3 different cases. Results: (1) this study established a three-dimensional nonlinear hexahedral finite element model with detailed anatomical structure. This model includes 86444 finite element cells, 88388 nodes, and a comparison. The stress distribution under the physiological load of this model is in accordance with the in vitro experiment and other literature model data. (2) the longitudinal displacement of the acetabular top and the lateral displacement of the inner wall of the rear column of the 3 internal fixed models at the simulated sitting position when loading 600N physiological load are CBA, and the longitudinal displacement of the fixed model molars in the three groups of A, B and C groups under the sitting position. Not (0.959 + 0.216), (0.970 + 0.220), (0.978 + 0.223) mm, the lateral displacement of the inner wall of the post column is (0.903 + 0.034), (0.930 + 0.045), (0.997 + 0.068), and the stress in the three internal fixation models is CBA, and the difference between C and A, B has obvious statistical significance (P0.05). In the A, B, C three groups, there was no significant difference in the longitudinal displacement of the fixed model in the three groups. The lateral displacement of the inner wall of the post column was (0.903 + 0.034), (0.910 + 0.038), (1.117 + 0.380) mm, and the stress in the DASPQ square area was ABC, and the difference was statistically significant. (1) a high simulation normal human body was established in this study. The three-dimensional nonlinear hexahedron finite element model of the pelvis is used to construct the basic pelvic ligament tissue, and the anatomical structure is complete so that the model can basically conform to the true situation of the pelvis. Through the corresponding validation of the model, the model can be used to carry out the biomechanical study related to the clinical. (2) the DAPSQ column is accompanied by the post treatment. The semi transverse acetabular fracture has good biomechanical stability. (3) DASPQ fixed anterior column with posterior half transverse acetabular fracture can provide better biomechanical stability on the premise of the stability of the contralateral pelvic ring.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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