Department of Mechanical and Biomedical Engineering, National University of Ireland, Galway, Ireland.
Med Eng Phys. 2013 Jun;35(6):712-22. doi: 10.1016/j.medengphy.2012.07.016. Epub 2012 Sep 16.
A computational investigation of proximal humeral fracture fixation has been conducted. Four devices were selected for the study; a locking plate, intramedullary nail (IM Nail), K-wires and a Bilboquet device. A 3D model of a humerus was created using a process of thresholding based on the grayscale values of a CT scan of an intact humerus. An idealised three part fracture was created in addition to removing a standard volume from the humeral head as a representation of bone voids that occur as a result of the injury. All finite element simulations conducted represent 90° arm abduction. Simulations were conducted to investigate the effect of filling this bone void with calcium phosphate cement for each device. The effect of constructing devices from carbon fibre polyetheretherketone (CFPEEK) was investigated. Simulations of cement reinforced devices predict greater stability for each device. The average unreinforced fracture line opening (FLO) is reduced by 48.5% for metallic devices with a lesser effect on composite devices with FLO reduced by 23.6%. Relative sliding (shear displacement) is also reduced between fracture fragments by an average of 58.34%. CFPEEK device simulations predict reduced stresses at the device-bone interface.
已经对肱骨近端骨折固定进行了计算研究。选择了四种设备进行研究：锁定板、髓内钉 (IM Nail)、K 型钉和 Bilboquet 装置。使用基于完整肱骨 CT 扫描灰度值的阈值处理过程创建了肱骨的 3D 模型。除了从肱骨头上移除标准体积以代表由于损伤而产生的骨空洞之外，还创建了理想化的三部分骨折。所有进行的有限元模拟都代表 90°手臂外展。进行模拟以研究为每个设备填充骨空洞的磷酸钙水泥的效果。研究了由碳纤维聚醚醚酮 (CFPEEK) 构建设备的效果。水泥增强设备的模拟预测每种设备的稳定性更高。未加固骨折线开口 (FLO) 的平均值降低了 48.5%，而复合材料设备的 FLO 降低了 23.6%，影响较小。骨折碎片之间的相对滑动（剪切位移）也平均减少了 58.34%。CFPEEK 设备模拟预测设备-骨界面的应力降低。
