Guo Zong-Hui, Yan Yong-Qing, Tang Yin, Wang Jun-Jie, Yang Chang-Chun, Pang Qing-Jiang
Department of Orthopaedics Centre, Huamei Hospital, University of Chinese Academy of Sciences, Ningbo 315010, Zhejiang, China.
Zhongguo Gu Shang. 2021 Feb 25;34(2):137-42. doi: 10.12200/j.issn.1003-0034.2021.02.008.
To explore biomechanical characteristics of minimally invasive different screw fixations in treating Sanders typeⅡcalcaneal fractures.
Dicom data of calcaneus by CT scan were input into Mimics 21.0 software and Ansys15.0 software to construct three-dimensional finite element digital model of calcaneus;this model was input into UG NX 10.0 software, and calcaneus was cut according to Sanders classification to establish Sanders typeⅡ calcaneus model with posterior articular surface collapse;then simulated minimally invasive screw internal fixation after calcaneal fracture:a screw from posterior articular surface was used to outside-in fix sustentaculum tali, other 4 screws were used to fix calcaneus by different methods through calcaneal tuberosity, and 4 different calcaneal models were obtained. Under the same conditions, 4 types of internal fixation models were loaded respectively, and nonlinear finite element analysis was performed to calculate the stress distribution of different internal fixation models.
Under the same condition of loading, the model 3 had smaller displacement value, maximum calcaneus displacement value and maximum equivalent stress value of the screw than other three internal fixation models, and the stress was more dispersed.
In minimally invasive screw internal fixation of calcaneus fracture, after 1 sustentaculum tali screw fixation, 2 screws crossed fix posterior articular surface from calcaneal tuberosity, 2 screws fix parallelly calcaneocuboid joint from calcaneal tuberosity are more suitable for biomechanical requirements, and could provide basic theory for clinical treatment.
探讨微创不同螺钉固定治疗SandersⅡ型跟骨骨折的生物力学特性。
将CT扫描的跟骨Dicom数据输入Mimics 21.0软件和Ansys15.0软件,构建跟骨三维有限元数字模型;将该模型输入UG NX 10.0软件,按照Sanders分型截骨建立后关节面塌陷的SandersⅡ型跟骨模型;然后模拟跟骨骨折后微创螺钉内固定:1枚螺钉从后关节面向外固定载距突,另外4枚螺钉通过跟骨结节采用不同方法固定跟骨,得到4种不同的跟骨模型。在相同条件下,分别对4种内固定模型加载,进行非线性有限元分析,计算不同内固定模型的应力分布。
在相同加载条件下,模型3的位移值、跟骨最大位移值及螺钉最大等效应力值均小于其他3种内固定模型,且应力分布更分散。
在跟骨骨折微创螺钉内固定中,1枚载距突螺钉固定后,2枚螺钉从跟骨结节交叉固定后关节面,2枚螺钉从跟骨结节平行固定跟骰关节更符合生物力学要求,可为临床治疗提供基础理论。