Shih Cheng-Min, Huang Kui-Chou, Pan Chien-Chou, Lee Cheng-Hung, Su Kuo-Chih
Department of Orthopaedics, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung City, Taiwan.
Department of Biological Science and Technology, National Chiao Tung University, Hsinchu City, Taiwan.
Int Orthop. 2015 Nov;39(11):2239-44. doi: 10.1007/s00264-015-2890-8. Epub 2015 Jul 17.
Clavicle hook plates are frequently used in clinical orthopaedics to treat acromioclavicular joint dislocation. However, patients often exhibit acromion osteolysis and per-implant fracture after undergoing hook plate fixation. With the intent of avoiding future complications or fixation failure after clavicle hook plate fixation, we used finite element analysis (FEA) to investigate the biomechanics of clavicle hook plates of different materials and sizes when used in treating acromioclavicular joint dislocation.
Using finite element analysis, this study constructed a model comprising four parts: clavicle, acromion, clavicle hook plate and screws, and used the model to simulate implanting different types of clavicle hook plates in patients with acromioclavicular joint dislocation. Then, the biomechanics of stainless steel and titanium alloy clavicle hook plates containing either six or eight screw holes were investigated.
The results indicated that using a longer clavicle hook plate decreased the stress value in the clavicle, and mitigated the force that clavicle hook plates exert on the acromion. Using a clavicle hook plate material characterized by a smaller Young's modulus caused a slight increase in the stress on the clavicle. However, the external force the material imposed on the acromion was less than the force exerted on the clavicle.
The findings of this study can serve as a reference to help orthopaedic surgeons select clavicle hook plates.
锁骨钩钢板在临床骨科中常用于治疗肩锁关节脱位。然而，患者在接受钩钢板固定后常出现肩峰骨质溶解和植入物周围骨折。为了避免锁骨钩钢板固定术后未来出现并发症或固定失败，我们采用有限元分析（FEA）来研究不同材料和尺寸的锁骨钩钢板在治疗肩锁关节脱位时的生物力学。
本研究利用有限元分析构建了一个包含四个部分的模型：锁骨、肩峰、锁骨钩钢板和螺钉，并使用该模型模拟在肩锁关节脱位患者中植入不同类型的锁骨钩钢板。然后，研究了含六个或八个螺孔的不锈钢和钛合金锁骨钩钢板的生物力学。
结果表明，使用更长的锁骨钩钢板可降低锁骨中的应力值，并减轻锁骨钩钢板对肩峰施加的力。使用杨氏模量较小的锁骨钩钢板材料会使锁骨上的应力略有增加。然而，该材料施加在肩峰上的外力小于施加在锁骨上的力。
本研究结果可为骨科医生选择锁骨钩钢板提供参考。
