Zmuda Trzebiatowski Marcin A, Kłosowski Paweł, Skorek Andrzej, Żerdzicki Krzysztof, Lemski Paweł, Koberda Mateusz
Department of Structural Mechanics, Faculty of Civil and Environmental Engineering, Gdańsk University of Technology, Gdańsk 80-233, Poland.
Department of Otolaryngology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk 80-210, Poland.
Appl Bionics Biomech. 2021 Mar 4;2021:8879847. doi: 10.1155/2021/8879847. eCollection 2021.
The more we know about mechanisms of the human orbital blowout type of trauma, the better we will be able to prevent them in the future. As long as the mechanism's veracity is not in doubt, the mechanism is not based on equally strong premises. To investigate the correctness of the hydraulic mechanism's theory, two different methods of implementation of the hydraulic load to the finite element method (FEM) model of the orbit were performed. The intraorbital hydraulic pressure was introduced as a face load applied directly to the orbit in the first variant, while in the second one the load was applied to the orbit indirectly as a set of nodal forces transferred from the external surface of the eyeball via the intraorbital tissues to the orbital walls within the contact problem. Such an approach is aimed at a better understanding of the pattern for the formation of blowout fractures during the indirect load applied to the orbital bones. The nonlinear dynamic analysis of both numerical models showed that the potential fracture was observed in the second variant only, embracing a relatively large area: both medial and lower wall of the orbit. Interestingly, the pressure generated by the intraorbital entities transferred the energy of the impact to the orbital sidewalls mainly; thus, the nature of the mechanism known as the was far from the expected hydraulic pressure. According to the eyeball's deformation as well as the areas of the greatest Huber-Mises-Hencky (H-M-H) stress within the orbit, a new term of was proposed instead of the mechanism as more realistic regarding the investigated phenomenon. The results of the current research may strongly influence the development of modern implantology as well as affect forensic medicine.
我们对人类眼眶爆裂性创伤机制了解得越多，未来就越能更好地预防此类创伤。只要该机制的真实性毋庸置疑，其并非基于同样有力的前提。为研究液压机制理论的正确性，对眼眶有限元模型（FEM）实施了两种不同的液压加载方法。在第一种变体中，眼眶内液压作为面载荷直接施加于眼眶；而在第二种变体中，载荷通过接触问题从眼球外表面经眶内组织传递至眶壁的一组节点力间接施加于眼眶。这种方法旨在更好地理解在间接加载眼眶骨时爆裂性骨折的形成模式。两个数值模型的非线性动力学分析表明，仅在第二种变体中观察到潜在骨折，涉及相对较大区域：眼眶内侧壁和下壁。有趣的是，眶内实体产生的压力主要将冲击力传递至眼眶侧壁；因此，所谓的液压机制的性质与预期的液压相差甚远。根据眼球变形以及眼眶内最大胡贝尔 - 米塞斯 - 亨奇（H - M - H）应力区域，提出了一个新术语来替代液压机制，因为它对于所研究的现象更具现实意义。当前研究结果可能会对现代植入学的发展产生重大影响，同时也会影响法医学。
