Xie Xian-Jin, Cao Sheng-Lu, Tong Kai, Zhong Zi-Yi, Wang Gang
Department of Orthopaedic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China.
Department of Orthopaedic Surgery, Zhongnan Hospital, Wuhan University, Wuhan 430000, Hubei Province, China.
World J Clin Cases. 2021 Mar 16;9(8):1814-1826. doi: 10.12998/wjcc.v9.i8.1814.
With the modernization of society and transportation in the last decades in China, the incidence of high-energy trauma increased sharply in China, including that of acetabular fractures.
To establish different finite element models for acetabular posterior column fractures involving the quadrilateral area of the acetabulum.
The three-dimensional models of the normal and fractured pelvis and the five internal fixations were established using the computed tomography data of the pelvis of a living volunteer. After the vertebral body model was inserted in the way of origin matching and all cancellous bones were copied using the duplicated cancellous bone model as the subtractive entity, the Boolean operation was performed on the pelvis model to obtain the model of the complete pelvis cortical and cancellous bones.
In the standing position, the maximum stress was 46.21 MPa. In the sitting position, the sacrum bore the simulated gravity load at the upper end. When comparing the five fixations, there were no significant differences in the stress mean values among groups (sitting: = 0.9794; standing: = 0.9741). In terms of displacement, the average displacement of the internal iliac plate group was smaller than that of the spring plate group ( = 0.002), and no differences were observed between the other pairs of groups (all > 0.05). In the standing position, there were no significant differences in the mean value of displacement among the groups ( = 0.2985). It can be seen from the stress nephogram of the internal fixations in different positions that the stress of the internal fixation was mainly concentrated in the fracture segment.
There were no significant differences among the fixations for acetabular posterior column fractures involving the quadrilateral area of the acetabulum.
在过去几十年中国社会和交通现代化进程中,中国高能创伤的发生率急剧上升,包括髋臼骨折。
建立涉及髋臼四边形区域的髋臼后柱骨折的不同有限元模型。
利用一名活体志愿者骨盆的计算机断层扫描数据,建立正常和骨折骨盆以及五种内固定的三维模型。以原点匹配的方式插入椎体模型,并用复制的松质骨模型作为减性实体复制所有松质骨后,对骨盆模型进行布尔运算,得到完整骨盆皮质骨和松质骨模型。
站立位时,最大应力为46.21MPa。坐位时,骶骨在上端承受模拟重力负荷。比较五种固定方式时,各组应力平均值之间无显著差异(坐位: = 0.9794;站立位: = 0.9741)。在位移方面,髂内钢板组的平均位移小于弹簧钢板组( = 0.002),其他组对之间未观察到差异(均 > 0.05)。站立位时,各组位移平均值之间无显著差异( = 0.2985)。从不同位置内固定的应力云图可以看出,内固定的应力主要集中在骨折段。
对于涉及髋臼四边形区域的髋臼后柱骨折,各种固定方式之间无显著差异。