Department of Orthopedics, First Affiliated Hospital of Xi'an Jiaotong University, No. 277, Yanta West Road, Yanta District, Xi'an, 710061, Shaanxi, China.
Department of Spine and Spinal Cord Surgery, Henan Provincial People's Hospital, No. 7, Weft Five Road, Jinshui District, Zhengzhou, 450003, Henan, China.
Comput Biol Med. 2021 Jun;133:104379. doi: 10.1016/j.compbiomed.2021.104379. Epub 2021 Apr 14.
Clavicular hook plates are frequently used in clinical orthopedics to treat acromioclavicular joint dislocation. However, patients often exhibit acromial osteolysis and peri-implant fracture after hook plate fixation. To solve the above problems, we developed a novel double-hook clavicular plate and used finite element analysis (FEA) to investigate its biomechanical properties.
A finite element (FE) model was constructed and validated. Then, a double-hook clavicular plate, a single-hook clavicular plate, and an anatomical double-hook clavicular plate was implanted into the acromioclavicular joint and fixed with screws in groups 1, 2 and 3, respectively. Finally, a load was applied, and some indicators were recorded and analyzed.
For both the proximal clavicular rotation angle and the distal clavicular displacement, the range of motion in groups 1 and 3 was more than 90% lower than that in group 2. The maximum von Mises stress of the clavicle in groups 1 and 3 was more than 45% lower than that in group 2. The maximum stress of the acromion in group 2 was significantly higher than that in groups 1 and 3, and that in group 3 was less than that in group 1, for both cortical and cancellous bone.
The double-hook clavicular plate could immediately reconstruct the stability of the acromioclavicular joint, effectively reducing the stress of the bone around the clavicle and screws. Additionally, the double-hook clavicular plate could reduce the peak stress of the acromion and produce a more uniform stress distribution.
锁骨钩板常用于临床骨科治疗肩锁关节脱位。然而，患者在钩板固定后常出现肩峰骨溶解和植入物周围骨折。为了解决上述问题，我们研制了一种新型双钩锁骨板，并采用有限元分析（FEA）对其生物力学特性进行了研究。
构建并验证了有限元（FE）模型。然后，将双钩锁骨板、单钩锁骨板和解剖双钩锁骨板分别植入肩锁关节，并用螺钉固定在第 1、2 和 3 组中。最后，施加负载，并记录和分析了一些指标。
对于锁骨近端旋转角度和锁骨远端位移，第 1 组和第 3 组的活动范围均比第 2 组高 90%以上。第 1 组和第 3 组锁骨的最大 von Mises 应力比第 2 组低 45%以上。第 2 组肩峰的最大应力明显高于第 1 组和第 3 组，而第 3 组的最大应力则低于第 1 组，无论是皮质骨还是松质骨都是如此。
双钩锁骨板可立即重建肩锁关节的稳定性，有效降低锁骨和螺钉周围骨的应力。此外，双钩锁骨板可降低肩峰的峰值应力，并产生更均匀的应力分布。
