Wang Mian, Deng Yuping, Xie Pusheng, Tan Jinchuan, Yang Yang, Ouyang Hanbin, Zhao Dongliang, Huang Gang, Huang Wenhua
National Key Discipline of Human Anatomy, Guangdong Provincial Key Laboratory of Medical Biomechanics, Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China.
Institute of Biomedical Engineering, Shenzhen Bay Laboratory, Shenzhen, China.
Front Bioeng Biotechnol. 2022 Feb 21;10:820921. doi: 10.3389/fbioe.2022.820921. eCollection 2022.
The treatment of fractures of the distal tibia can be problematic due to the insubstantial soft-tissue covering this part of the anatomy. This study investigates a novel strategy for minimally invasive plate osteosynthesis of distal tibia fractures called bionic lightweight design plating. Following the structure of the animal trabecular bone, we utilized topological mathematical methods to redesign the material layout of the internal fixation device to fulfill the desired lightweight design within given boundary conditions. The results showed that this method can maintain the same stability of the construct as the original plate after a reduction in the original volume by 30%, and the differences in strain energy of plates and maximum node displacement of constructs between the constructs [RP construct LP construct] were not statistically significant ( > 0.05). In the safety assessment of the constructs, the peak stress of plates between constructs was found to not be statistically significantly different under a doubled physiological load ( > 0.05). The average stress of the plates' elements exceeding the allowable stress was analyzed, and no statistically significant differences were found between the two constructs under axial compression stress conditions ( > 0.05). The average stress of the plates' elements in the redesigned plating construct under torsional stress conditions was 3.08% less than that of the locked plating construct ( < 0.05). Under the double physiological load condition, 89% of the elements of the plate in the redesigned plating construct and 85% of the elements of the plate in the locked plating construct were lower than the maximum safe stress of the plate, which was 410 MPa (secondary allowable stresses). That reminds us the topology optimization offer a possible way to improve the capacity of soft tissue protection while ensuring the safety of the RP construct by reducing the volume of the implants.
由于胫骨远端这一解剖部位的软组织覆盖较少，其骨折的治疗可能会存在问题。本研究探讨了一种用于胫骨远端骨折微创钢板接骨术的新策略，即仿生轻量化设计钢板。我们遵循动物松质骨的结构，利用拓扑数学方法重新设计内固定装置的材料布局，以在给定边界条件下实现所需的轻量化设计。结果表明，该方法在将原始体积减少30%后，能保持与原始钢板相同的结构稳定性，并且两种结构[RP结构和LP结构]之间钢板的应变能差异和结构的最大节点位移差异无统计学意义（P>0.05）。在结构的安全性评估中，发现两种结构的钢板在生理负荷加倍时的峰值应力无统计学显著差异（P>0.05）。分析了超过允许应力的钢板单元的平均应力，发现在轴向压缩应力条件下两种结构之间无统计学显著差异（P>0.05）。在扭转应力条件下，重新设计的钢板结构中钢板单元的平均应力比锁定钢板结构低3.08%（P<0.05）。在生理负荷加倍的条件下，重新设计的钢板结构中89%的钢板单元和锁定钢板结构中85%的钢板单元低于钢板的最大安全应力410MPa（二级允许应力）。这提醒我们，拓扑优化为在确保RP结构安全的同时，通过减少植入物体积来提高软组织保护能力提供了一种可能的方法。
