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[骨盆后环微创螺钉设计及骨盆有限元分析]

[Design of Minimal Invasive Screw on Posterior Pelvis Ring and Pelvic Finite Element Analysis].

作者信息

Tang Fan, Min Li, Wang Yan-Ling, Qu Bo, Zhou Yong, Luo Yi, Zhang Wen-Li, Shi Rui, Duan Hong, Tu Chong-Qi

机构信息

Department of Orthopedics,West China Hospital,Sichuan University,Chengdu 610041,China.

出版信息

Sichuan Da Xue Xue Bao Yi Xue Ban. 2017 Sep;48(5):673-680.

Abstract

OBJECTIVE

To design minimal invasive screw on posterior pelvic ring and perform threedimensional finite element analysis based on a pelvis finite element model.

METHODS

We measured the pelvic anatomical data of 20 healthy volunteers and identified potential designs for minimal invasive screw on posterior pelvic ring. A finite element model of pelvis was then established. Threedimensional finite element analyses were performed under static and dynamic mechanical loading,respectively.

RESULTS

Three screw tracks on ilium (A,B and C) were identified based on a threedimensional reconstruction of pelvis. Nail track B and C had greater length and width,but shorter distance between nailing and soft tissue compared with nail track A. Static loading under an external rotation load of 500 N generated a maximum Mises Von stress of 582.05 Pa and sacral iliac complex of 107.38 Pa. The greatest strain was located at the articular cartilage on the side of the nail,followed by lateral sacral joint cartilage and symphysis pubis. The largest displacement was located at the ilium on the side of the nail,with a gradient decrease to the opposite side. The largest displacement of the anterior superior iliac spine was 0.35 cm on the side of the nail. The dynamic loading identified displacement of the anterior superior iliac spine with 1.5 mm in axis,1.8 mm in axis and -0.2 mm in axis; and displacement of the pubic bone with 0.8 mm in axis,1.0 mm in axis and 0.03 mm in axis. The maximum displacement appeared along the impact direction: axis. Relatively large equivalent stress was found in pubis and ischium,anterior superior iliac spine,sacrum,acetabular that are prone to fracture. With increased impact force,the stress of pelvis increased over time. The maximum impact force,stress and displacement of the pelvis occurred at 10 ms when peak force was reached. Under the impact of 4 000 N and 5 000 N,the bone was subject to a stress level of over 200 MPa,exceeding its average yield strength,which suggests a possibility of pelvic fracture.

CONCLUSION

Taking B/C as a main screw track and A as an auxiliary screw track is a reasonable choice. The pelvic finite element model lays a foundation for further studies into sacral fracture and design of screw tracks.

摘要

目的

设计骨盆后环微创螺钉并基于骨盆有限元模型进行三维有限元分析。

方法

测量20名健康志愿者的骨盆解剖数据,确定骨盆后环微创螺钉的潜在设计。然后建立骨盆有限元模型。分别在静态和动态机械载荷下进行三维有限元分析。

结果

基于骨盆三维重建确定了髂骨上的三条螺钉轨迹(A、B和C)。与轨迹A相比,轨迹B和C的长度和宽度更大,但钉道与软组织之间的距离更短。在500 N外旋载荷下的静态加载产生的最大米塞斯冯应力为582.05 Pa,骶髂复合体为107.38 Pa。最大应变位于钉侧的关节软骨处,其次是骶外侧关节软骨和耻骨联合。最大位移位于钉侧的髂骨处,向对侧呈梯度减小。钉侧髂前上棘的最大位移为0.35 cm。动态加载确定髂前上棘在x轴上的位移为1.5 mm,在y轴上为1.8 mm,在z轴上为-0.2 mm;耻骨在x轴上的位移为0.8 mm,在y轴上为1.0 mm,在z轴上为0.03 mm。最大位移出现在冲击方向:z轴。在耻骨、坐骨、髂前上棘、骶骨、髋臼等易骨折部位发现相对较大的等效应力。随着冲击力增加,骨盆应力随时间增加。当达到峰值力时,骨盆的最大冲击力、应力和位移出现在10 ms时。在4000 N和5000 N的冲击下,骨承受的应力水平超过200 MPa,超过其平均屈服强度,提示有骨盆骨折的可能性。

结论

以B/C为主螺钉轨迹、A为辅助螺钉轨迹是合理选择。骨盆有限元模型为进一步研究骶骨骨折和螺钉轨迹设计奠定了基础。

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