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定制型接骨板(CDBP)与锁定加压接骨板(LCP)治疗股骨远端骨折时应力与应变的比较

The comparison of stress and strain between custom-designed bone plates (CDBP) and locking compression plate (LCP) for distal femur fracture.

作者信息

Shams Seyedeh Fatemeh, Mehdizadeh Alireza, Movahedi Mohammad Mehdi, Paydar Shahram, Haghpanah Seyyed Arash

机构信息

Department of Medical Physics and Biomedical Engineering, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Ionizing and Non-Ionizing Radiation Protection Research Center (INIRPRC), School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Eur J Orthop Surg Traumatol. 2023 Jan;33(1):191-197. doi: 10.1007/s00590-021-03160-4. Epub 2022 Jan 10.

Abstract

BACKGROUND

Distal femur fracture is considered one of the most common fractures due to high-energy traumas such as car accidents or low-energy traumas such as osteoporosis. Locking plates are orthopedic implants used for stabilized femur fracture. Thus, designing a bone plate fitted exactly with the patient's bone and correctly fixing bone segments are required for better fracture healing.

OBJECTIVES

This study aims to design a bone plate based on anthropometric characteristics of patients' femurs and compare performing custom-designed bone plates (CDBP) with the locking compression plate (LCP) by finite element method.

MATERIALS AND METHODS

In this analytical study, a 3D model of four patients' femur and CDBP were firstly designed in MIMICS 19.0 based on the patient's femur anatomy. After designing the bone plate, the CDBPs and LCP were fixed on the bone and analyzed by finite element method (FEM) in ANSYS, and stress and strain of bone plates were also compared.

RESULTS

The maximum principal stress for all 3D models of patients' fracture femur by CDBPs was stabilized better than LCP with a decrease by 39.79, 12.54, 9.49, and 20.29% in 4 models, respectively. Also, in all models, the strain of CDBPs is less than LCP. Among the different thicknesses considered, the bone plate with 5 mm thickness showed better stress and strain distribution than other thicknesses.

CONCLUSION

Customized bone plate designed based on patient's femur anatomical morphology shows better bone-matching plate, resulting in increasing the quality of the fracture healing and fails to any need for additional shaping.

TRIAL REGISTRATION NUMBER

Design and analysis of an implant were investigated in this study. There was no intervention in the diagnosis and treatment of patients and the study was not a clinical trial.

摘要

背景

股骨远端骨折被认为是最常见的骨折之一,其成因包括车祸等高能量创伤或骨质疏松等低能量创伤。锁定钢板是用于稳定股骨骨折的骨科植入物。因此,为了实现更好的骨折愈合,需要设计一种与患者骨骼精确匹配的骨板并正确固定骨段。

目的

本研究旨在基于患者股骨的人体测量学特征设计一种骨板,并通过有限元方法将定制设计的骨板(CDBP)与锁定加压钢板(LCP)进行性能比较。

材料与方法

在这项分析性研究中,首先在MIMICS 19.0中基于患者的股骨解剖结构设计了四名患者的股骨三维模型和CDBP。设计骨板后,将CDBP和LCP固定在骨头上,并在ANSYS中通过有限元方法(FEM)进行分析,同时还比较了骨板的应力和应变。

结果

CDBP对所有患者骨折股骨三维模型的最大主应力的稳定效果均优于LCP,在4个模型中分别降低了39.79%、12.54%、9.49%和20.29%。此外,在所有模型中,CDBP的应变均小于LCP。在考虑的不同厚度中,5毫米厚的骨板显示出比其他厚度更好的应力和应变分布。

结论

基于患者股骨解剖形态设计的定制骨板显示出更好的骨匹配性,从而提高了骨折愈合质量,且无需额外塑形。

试验注册号

本研究对一种植入物进行了设计和分析。本研究未对患者的诊断和治疗进行干预,且该研究并非临床试验。

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