Kimsal Julie, Baack Bret, Candelaria Lionel, Khraishi Tariq, Lovald Scott
Mechanical Engineering Department, University of New Mexico, Albuquerque, NM, USA.
J Oral Maxillofac Surg. 2011 Dec;69(12):3010-4. doi: 10.1016/j.joms.2010.12.042. Epub 2011 Apr 15.
Clinical evidence has suggested that minimal fixation can reduce complications of mandibular angle fractures, though no detailed biomechanical model has yet explored this unique and somewhat unexpected finding.
The current study uses finite element analysis to biomechanically evaluate different fixation schemes used to fixate mandibular angle fractures. Three fixation scenarios were considered: a single tension band at the superior mandibular border, a single bicortical angle compression plate at the inferior border and the tension band and bicortical plate used together.
The dual plate model incurred the lowest von Mises stresses in the plates and the lowest principal strain in the callus. The tension band model observed the highest plate and screw von Mises stresses, but had fracture-site callus strain near to that of the dual plate model. The bicortical angle compression plate model observed the highest fracture-site callus strain.
The results from this study support the use of the single tension band configuration as a less invasive fixation approach to fractures of the mandibular angle. This is the first known study to explore and confirm clinical observations of angle fracture fixation outcomes with a detailed biomechanical modeling methodology.
临床证据表明，微创固定可减少下颌角骨折的并发症，尽管尚无详细的生物力学模型探讨这一独特且出人意料的发现。
本研究采用有限元分析，对用于固定下颌角骨折的不同固定方案进行生物力学评估。考虑了三种固定方案：下颌骨上缘单张力带、下颌骨下缘单双皮质角加压钢板以及张力带和双皮质钢板联合使用。
双钢板模型在钢板中产生的von Mises应力最低，在骨痂中产生的主应变最低。张力带模型观察到钢板和螺钉的von Mises应力最高，但骨折部位骨痂应变与双钢板模型相近。双皮质角加压钢板模型观察到骨折部位骨痂应变最高。
本研究结果支持使用单张力带构型作为下颌角骨折的一种侵入性较小的固定方法。这是首次使用详细的生物力学建模方法探索并证实角骨折固定结果临床观察的研究。
