智能气囊小夹板通过动力气囊压垫纠正桡骨远端AO C3.1型骨折手法复位后残余移位的三维有限元分析研究

发布时间：2018-09-17 16:03

【摘要】：目的:运用三维有限元分析方法对智能气囊小夹板通过动力气囊压垫纠正桡骨远端AO C3.1型骨折手法复位后残余侧方移位、成角移位、旋转移位的压强调整大小进行量化研究,验证其纠正桡骨远端骨折残余移位的有效性、复位后的腕关节生物力学固定稳定性。方法:以桡骨远端骨折AO分型C3.1型骨折为研究对象,通过Mimics 15.0,Imageware 13.0,Ansysworkbench 15.0等三维FE建模分析软件,参照顾东云主编《骨折分类三维图典》仿真建模,建造桡骨远端伸直位损伤机制AO C3.1型骨折及骨折手法复位后残余背侧与桡侧1cm侧方移位、掌侧成角30°移位,旋转成角30°移位。高效仿真模拟智能气囊小夹板固定后通过动力智能气囊压垫压强调整纠正桡骨远端AO C3.1型骨折手法复位后残余移位,对残余移位纠正距离及角度大小与气囊压垫压强调整大小之间关系进行量化研究,并对残余移位纠正后的腕关节骨与软组织生物力学固定稳定性进行分析研究。结果:通过FE分析研究得出,在智能气囊扎带压强恒定载荷下,动力气囊压垫压强连续调整过程中,腕部的应力云图深染主要集中分布在腕背侧及桡侧,以气囊压垫存在部位的骨折断端为著,FE分析软件计算得到C3.1型骨折腕关节局部软组织应力最大值为0.080592MPa,骨折缝处应力值为2.1259MPa,纠正桡侧残余1mm移位需调整气囊压垫压强大小约2.4KPa,背侧1mm移位需调整压垫压强大小约1.3KPa,纠正5°成角移位所需调整气囊压垫压强为4.7KPa,纠正旋转成角5°所需调整气囊压垫压强为3.3KPa。骨折复位后将动力气囊压垫泄压,此时,骨折块间的摩擦力及气囊扎带的约束力可有效维持复位效果,并防止其再移位。结论:智能气囊小夹板对桡骨远端C3.1型骨折固定稳定。在残余移位纠正中,可通过调整动力气囊压垫压强有效纠正骨折手法复位后残余背侧与桡侧1cm侧方移位、成角30°移位,旋转成角30°移位,气囊压垫泄压后外在气囊扎带的恒定约束载荷与骨折块间的摩擦应力可维持复位后的固定效果,并防止其再移位。
[Abstract]:Objective: To quantify the residual lateral displacement, angular displacement and rotational displacement of AO C3.1 distal radius fractures after manual reduction with smart balloon splint through dynamic balloon pad by three-dimensional finite element analysis, and to verify the validity of the smart balloon splint in correcting the residual displacement of distal radius fractures. Methods: Taking AO type C3.1 fracture of distal radius as the research object, three-dimensional FE modeling and analysis software such as Mimics 15.0, Imageware 13.0 and Ansysworkbench 15.0 were used to construct AO type C3.1 fracture and bone injury mechanism in distal extension of radius by taking care of Dongyun's edited < fracture classification three-dimensional atlas > simulation modeling. After manual reduction, residual dorsal and radial 1 cm lateral displacement, volar angular displacement of 30 degrees, rotation of 30 degrees displacement. Efficient simulation of small smart balloon splint fixation by dynamic smart balloon pressure pad stress correction of distal radius AO C 3.1 fracture after manual reduction residual displacement, residual displacement correction distance and angle size and angle Results: FE analysis showed that the wrist stress in the process of continuous adjustment of dynamic balloon pressure pad pressure under constant pressure of smart balloon band was obtained. Cloud staining mainly distributed in the dorsal and radial side of the wrist, especially in the fractured end where the balloon cushion existed. FE analysis software calculated the maximum value of local soft tissue stress of the wrist joint of type C3.1 fracture was 0.080592 MPa, and the stress value of the fracture suture was 2.1259 MPa. 1 mm posterior displacement requires adjusting the pressure of the balloon to about 1.3 KPa, 4.7 KPa for correcting the angular displacement of 5 degrees, 3.3 KPa for correcting the angular displacement of 5 degrees, and 3.3 KPa for correcting the angular displacement of 5 degrees. Conclusion: Intelligent balloon splint is stable for the fixation of distal radius fracture type C3.1. In the remnant displacement correction, the residual displacement of the dorsal and radial side of the fracture can be effectively corrected by adjusting the pressure of the dynamic balloon pad after manual reduction. The residual displacement is 30 degrees and rotated to 30 degrees. Constant restraint load of the capsule ligament and the friction stress between the fragments can maintain the fixation effect after reduction and prevent its relocation.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R274.1

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