Akiko Kimura, Nagasao Tomohisa, Kaneko Tsuyoshi, Miyamoto Junpei, Nakajima Tatsuo
Department of Plastic and Reconstructive Surgery, School of Medicine, Keio University.
Keio J Med. 2006 Mar;55(1):1-8. doi: 10.2302/kjm.55.1.
The purpose of this study is to determine the most stable fixation method for mandibular symphysis fractures by comparing the mechanical characteristics of models fixed at different positions with different numbers of plates. Fractures were generated in 3-dimensional finite element models, and were fixed with a single miniplate, parallel double miniplates, or perpendicular double miniplates. A 300 N perpendicular load was then applied on the left molar region, and a finite element analysis was performed. We compared vertical gaps between the fractured surfaces, maximum stress within the screw/plating system, and maximum stress around screw holes in the bone. Compared to the single miniplate, both the parallel and perpendicular double miniplates demonstrated significantly less stress in the screw/plating system and screw holes in the bone. In addition, the perpendicular double miniplateshad significantly smaller vertical gaps between fracture surfaces when compared to the single miniplate. Comparing parallel and perpendicular double miniplate fixations, less stress was found around the screw holes of the perpendicular miniplate models than those of the parallel miniplatemodels. There were no differences in vertical gaps or maximum stress within the screw/plating systems between the 2 double miniplate fixations. These results suggest that perpendicular double miniplate fixation is more suitable for fixing mandibular symphysis fractures.
本研究的目的是通过比较不同位置用不同数量钢板固定的模型的力学特性,确定下颌骨联合骨折最稳定的固定方法。在三维有限元模型中制造骨折,并用单个微型钢板、平行双微型钢板或垂直双微型钢板进行固定。然后在左磨牙区施加300 N的垂直载荷,并进行有限元分析。我们比较了骨折面之间的垂直间隙、螺钉/钢板系统内的最大应力以及骨螺钉孔周围的最大应力。与单个微型钢板相比,平行和垂直双微型钢板在螺钉/钢板系统和骨螺钉孔中的应力均显著较小。此外,与单个微型钢板相比,垂直双微型钢板在骨折面之间的垂直间隙明显更小。比较平行和垂直双微型钢板固定,垂直微型钢板模型螺钉孔周围的应力比平行微型钢板模型的小。两种双微型钢板固定在垂直间隙或螺钉/钢板系统内的最大应力方面没有差异。这些结果表明,垂直双微型钢板固定更适合于固定下颌骨联合骨折。