Strafun Sergey, Levadnyi Ievgen, Makarov Vasily, Awrejcewicz Jan
1Department of Microsurgery, Reconstructive and Corrective Surgery of the Upper Extremity, Academy of Medical Sciences of Ukraine, Research Institute of Traumatology and Orthopaedics, 27 Bulvarno-Kudrjavskaja St., Kiev, 01601 Ukraine.
2Department of Automation, Biomechanics and Mechatronics, Lodz University of Technology, 1/15 Stefanowski St., 90-924 Lodz, Poland.
J Med Biol Eng. 2018;38(4):618-624. doi: 10.1007/s40846-017-0334-1. Epub 2017 Sep 26.
Radial head fractures are becoming a major public health problem and are an increasingly important target for both clinical and mechanical researchers. In this work, comparative biomechanical analyses of the stress-strain state of a healthy elbow joint and elbow joints with radial head compression from 2 to 5 mm due to injury are performed. Three-dimensional models of the elbow joint with cartilage surfaces and ligaments were constructed based on the results of computed tomography. This study is focused on an elbow joint range of motion ranging from 0° to 120° flexion. Analysis of the stress-strain state of cartilage and ligaments under the influence of functional loads is conducted using a finite element method (FEM) and the ABAQUS software package. The results show that with increasing compression of the radial head, contact stress increases at the olecranon, which can lead to cartilage damage. Analysis of displacement shows that compression of the radial head during full extension of the elbow joint leads to an increased humeral shift from 1.14° ± 0.22 in the healthy joint to 10.3° ± 2.13 during 5-mm compression of the radial head. Mathematical modeling performed in this study proved that reducing the height of the radial head and the contact area between the radial head and the humeral head led to increased medial collateral ligament stresses of up to 36 ± 3.8 MPa. This work confirmed that the head of the radius is the main stabilizing structure of the elbow joint and that the medial collateral ligament is the second structure responsible for valgus stability of the elbow joint.
桡骨头骨折正成为一个重大的公共卫生问题，并且日益成为临床和力学研究人员越来越重要的研究对象。在这项工作中，对健康肘关节以及因损伤导致桡骨头压缩2至5毫米的肘关节的应力应变状态进行了比较生物力学分析。基于计算机断层扫描的结果构建了具有软骨表面和韧带的肘关节三维模型。本研究聚焦于肘关节从0°至120°屈曲的运动范围。使用有限元方法（FEM）和ABAQUS软件包对功能载荷影响下软骨和韧带的应力应变状态进行分析。结果表明，随着桡骨头压缩程度的增加，鹰嘴处的接触应力增大，这可能导致软骨损伤。位移分析表明，在肘关节完全伸展过程中桡骨头的压缩会导致肱骨移位增加，从健康关节的1.14°±0.22增加到桡骨头压缩5毫米时的10.3°±2.13。本研究中进行的数学建模证明，桡骨头高度的降低以及桡骨头与肱骨头之间接触面积的减小会导致内侧副韧带应力增加，最高可达36±3.8兆帕。这项工作证实了桡骨头是肘关节的主要稳定结构，并且内侧副韧带是负责肘关节外翻稳定性的第二结构。
