[1]章浩伟,吕琳,裴潇倜,等.桡骨远端钢板联合拉力钉固定治疗Sander III型跟骨骨折的生物力学分析[J].中国医学物理学杂志,2021,38(4):505-510.[doi:DOI:10.3969/j.issn.1005-202X.2021.04.020]
　ZHANG Haowei,L?Lin,PEI Xiaoti,et al.Biomechanical analysis of combining distal radius plate with transfixation screw for Sanders III calcaneal fracture[J].Chinese Journal of Medical Physics,2021,38(4):505-510.[doi:DOI:10.3969/j.issn.1005-202X.2021.04.020]
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桡骨远端钢板联合拉力钉固定治疗Sander III型跟骨骨折的生物力学分析()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
38卷
期数:
2021年第4期
页码:
505-510
栏目:
生物材料与力学
出版日期:
2021-04-29

文章信息/Info

Title:
Biomechanical analysis of combining distal radius plate with transfixation screw for Sanders III calcaneal fracture
文章编号:
1005-202X（2021）04-0505-06
作者:
章浩伟1; 吕琳1; 2; 裴潇倜1; 黄鹏杰1; 孙万驹2; 倪明1; 2; 祝晓忠3
1.上海理工大学医疗器械与食品学院， 上海 200093； 2.上海市健康医学院附属浦东新区人民医院骨科， 上海 201299； 3.同济大学附属同济医院骨科， 上海 200136
Author(s):
ZHANG Haowei1;  L?Lin1;  2;  PEI Xiaoti1;  HUANG Pengjie1;  SUN Wanju2;  NI Ming1;  2;  ZHU Xiaozhong3
1. School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China 2. Department of Orthopaedics, Pudong New Area Peoples Hospital, Shanghai University of Medicine and Health Sciences, Shanghai 201299, China 3. Department of Orthopaedics, Tongji Hospital Affiliated to Tongji University, Shanghai 200136, China
关键词:
跟骨骨折; 两点固定; 拉力钉; 负重行走; 康复训练
Keywords:
Keywords: calcaneal fracture two-point fixation transfixation screw weight-bearing walking rehabilitation training
分类号:
R318
DOI:
DOI:10.3969/j.issn.1005-202X.2021.04.020
文献标志码:
A
摘要:
提出并分析桡骨远端钢板（两点支撑）联合拉力钉固定治疗跟骨骨折的生物力学稳定性。在完整下肢骨骼-肌肉有限元模型的基础上，建立Sanders III型跟骨骨折模型并模拟固定，用桡骨远端钢板（两点支撑）联合拉力钉固定治疗骨折。评估该模型在静态站立和行走状态（足跟着地期、站立中期和推离期）的应力分布和位移情况。跟骨的应力集中于骨折端、跟骨与跟腱连接处，峰值为96.92 MPa。内固定的应力集中于钢板螺钉与载距突和跟骨结节接触位置，峰值为883.20 MPa。后关节面位移、Bohler角和Gissanes角均维持较好。桡骨远端钢板联合拉力钉固定治疗跟骨骨折具有良好的生物力学稳定性，体现微创原则，操作简单，术后可以早期康复训练，值得临床推广应用。
Abstract:
Abstract: A combination of distal radius plate (two-point fixation mechanism) and transfixation screw for the treatment of Sanders III calcaneal fractures is proposed, and its biomechanical stability is evaluated. Based on the skeleton-muscle finite element model of the lower extremity, a model of Sanders III calcaneal fracture is established, and then fixed by distal radius plate (two-point fixation mechanism) combined with transfixation screw. The biomechanical performances of the fracture model during static standing and 3 gait phases (heel-strike, mid-stance and push-off) are analyzed in terms of stress distribution and fracture displacement. The stress of the calcaneus under load condition concentrates on the junction of fracture end, calcaneus and Achilles tendon, with a peak value of 96.92 MPa, while the stress of the internal implant concentrates on the position where plate screw is in contact with sustentaculum tail and calcaneal tubercle, with a peak value of 883.20 MPa. The posterior articular displacement, Bohlers Angle and Gissanes Angle all maintain at a good condition. The combination of distal radius plate and transfixation screw for the treatment of calcaneal fracture has the advantages of sufficient biomechanical stability, minimal invasion and simple operation, and it can further facilitate early postoperative rehabilitation training. The proposed approach can serve as a new recommended fixation modality for the treatment of Sanders III calcaneal fracture, worthy of clinical application.

备注/Memo

备注/Memo:
【收稿日期】2020-12-11 【基金项目】上海市浦东新区卫生系统优秀学科带头人项目（PWRd2019-05）；上海健康医学院师资百人库项目（B3-0200-311008） 【作者简介】章浩伟，副教授，研究方向：生物力学，E-mail: howiezh@aliyun.com 【通信作者】倪明，副主任医师，研究生导师，研究方向：生物力学，E-mail:gendianqing@163.com；祝晓忠，副主任医师，研究方向：创伤骨科，E-mail: 805725811@qq.com
更新日期/Last Update: 2021-04-29