Huempfner-Hierl Heike, Schaller Andreas, Hierl Thomas
Department of Oral and Maxillofacial Plastic Surgery, Leipzig University, Liebigstrasse 12, 04103, Leipzig, Germany.
Scand J Trauma Resusc Emerg Med. 2015 Apr 21;23:35. doi: 10.1186/s13049-015-0117-z.
Severe facial trauma is often associated with intracerebral injuries. So it seemed to be of interest to study stress propagation from face to neurocranium after a fistlike impact on the facial skull in a finite element analysis.
A finite element model of the human skull without mandible consisting of nearly 740,000 tetrahedrons was built. Fistlike impacts on the infraorbital rim, the nasoorbitoethmoid region, and the supraorbital arch were simulated and stress propagations were depicted in a time-dependent display.
Finite element simulation revealed von Mises stresses beyond the yield criterion of facial bone at the site of impacts and propagation of stresses in considerable amount towards skull base in the scenario of the fistlike impact on the infraorbital rim and on the nasoorbitoethmoid region. When impact was given on the supraorbital arch stresses seemed to be absorbed.
As patients presenting with facial fractures have a risk for craniocerebral injuries attention should be paid to this and the indication for a CT-scan should be put widely. Efforts have to be made to generate more precise finite element models for a better comprehension of craniofacial and brain injury.
严重面部创伤常伴有脑内损伤。因此，在有限元分析中，研究面部颅骨受到类似拳头撞击后应力从面部向颅神经颅骨的传播情况似乎很有意义。
建立了一个不含下颌骨的人类颅骨有限元模型，该模型由近740,000个四面体组成。模拟了对眶下缘、鼻眶筛区域和眶上弓的类似拳头的撞击，并在随时间变化的显示中描绘了应力传播情况。
有限元模拟显示，在眶下缘和鼻眶筛区域受到类似拳头撞击的情况下，撞击部位的面部骨骼应力超过屈服准则，并且有相当数量的应力向颅底传播。当对眶上弓进行撞击时，应力似乎被吸收了。
由于面部骨折患者有颅脑损伤的风险，对此应予以关注，并应广泛采用CT扫描作为检查指征。必须努力生成更精确的有限元模型，以便更好地理解颅面和脑损伤。
