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采用患者特异性双组件接骨板增强的常规小片段螺钉对 p 型髁突头骨折进行生物力学评估。

Biomechanical evaluation of type p condylar head osteosynthesis using conventional small-fragment screws reinforced by a patient specific two-component plate.

机构信息

Department of Stomatology, O.O. Bogomolets National Medical University, Kyiv, Ukraine.

Department of Oral and Craniomaxillofacial Surgery, UKGM GmbH, University Hospital Marburg and Philipps University Marburg, Marbug, Germany.

出版信息

Head Face Med. 2020 Oct 19;16(1):25. doi: 10.1186/s13005-020-00236-0.

Abstract

BACKGROUND

The aim of this study was to evaluate via finite element analysis (FEA) the biomechanical behavior of conventional small-fragment screws reinforced by a patient-specific plate in type p condylar head.

METHODS

A finite element model of the mandible was created using Mimics 12.1 software. A type p condylar head fracture was simulated in the right condyle, and the left condyle was used as a control. Two patterns of fixation were investigated: conventional two-screw fixation and the same fixation system reinforced with a small, patient-specific plate. Surface models were imported into the software Ansys 5.7for further volume mesh generation.

RESULTS

The highest stress gradients were observed in the cortical layer of the lateral fragment, located near the screw. The conventional fixation method resulted in equivalent stresses 2 to 10 times greater than the reinforced method. Rigidity of fixation in the reinforced method increased up to 1.25-3 times compared to the conventional two-screw technique.

CONCLUSION

This study's findings suggest significant benefits in unfavorable biomechanical conditions from reinforcement of the standard two-screw fixation of condylar head fractures with a small, patient-specific plate acting as a washer.

摘要

背景

本研究旨在通过有限元分析(FEA)评估患者专用钢板增强的传统小片段螺钉在 p 型髁突头中的生物力学行为。

方法

使用 Mimics 12.1 软件创建下颌骨的有限元模型。在右侧髁突模拟 p 型髁突头骨折,左侧髁突作为对照。研究了两种固定方式:传统的双螺钉固定和相同的固定系统,用小的、患者专用的钢板增强。表面模型被导入到软件 Ansys 5.7 中进行进一步的体积网格生成。

结果

最高的应力梯度出现在靠近螺钉的外侧骨块的皮质层。传统的固定方法导致的等效应力比增强方法大 2 到 10 倍。与传统的双螺钉技术相比,增强方法的固定刚度增加了 1.25-3 倍。

结论

本研究的结果表明,在不利的生物力学条件下,用小的、患者专用的钢板作为垫圈增强髁突头骨折的标准双螺钉固定具有显著的优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07da/7574441/490c1167beba/13005_2020_236_Fig1_HTML.jpg

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