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骨科手术中基于非傅里叶热传递的钻骨温度效应:理论与体外实验研究。

Effects of non-Fourier bioheat transfer on bone drilling temperature in orthopedic surgery: Theoretical and in vitro experimental investigation.

机构信息

School of Railway Engineering, Iran University of Science and Technology, Tehran, Iran.

出版信息

Proc Inst Mech Eng H. 2022 Jun;236(6):811-824. doi: 10.1177/09544119221089122. Epub 2022 Apr 29.

DOI:10.1177/09544119221089122
PMID:35486132
Abstract

The mechanical drilling process is a typical step in treating bone fractures to fix broken parts with screws and plates. Drilling generates a significant amount of heat and elevates the temperature of the bone, which can cause thermal osteonecrosis and damage to the surrounding bone tissue and nerves. Thermal inertia between heat flux and temperature gradient in nonhomogeneous interior structural medium-like biological tissues is arguable. Therefore, this paper proposes an analytical model of heat propagation in bone drilling for orthopedic surgery based on the hyperbolic Pennes bioheat transfer equation (HPBTE). Drilling experiments in bovine cortical bone samples were also carried out using an infrared thermography approach to confirm the proposed analytical model. Around the drilled hole surface, thermal necrosis is spread out from 1 to 10 mm. Increased feed rate reduces necrosis penetration distance and increases intense bone necrosis. The HPBTE includes thermal relaxation time effect and internal convective function of tissue perfusion rate. As these factors are not considered in the parabolic heat transfer equation (PHTE), the results show that the HPBTE is more accurate in predicting temperature and thermal osteonecrosis than the PHTE. As a result, proposed analytical model is a handy tool for calculating temperature to avoid thermal damage while improving process efficiency. Furthermore, it has the capability of controlling the manual or robotic drilling procedure for minimally invasive operations.

摘要

机械钻孔过程是治疗骨折的典型步骤,用螺丝和钢板固定骨折部位。钻孔会产生大量的热量,使骨温升高,从而导致热骨坏死和周围骨组织及神经损伤。在非均匀的内部结构介质(如生物组织)中,热流和温度梯度之间的热惯性是有争议的。因此,本文提出了一种基于双曲型 Pennes 生物传热方程(HPBTE)的骨科手术骨钻传热分析模型。还通过红外热成像方法对牛皮质骨样本进行了钻孔实验,以验证所提出的分析模型。在钻孔表面周围,热坏死从 1 毫米扩展到 10 毫米。增加进给速度会减少坏死的穿透距离,并增加强烈的骨坏死。HPBTE 包括热弛豫时间效应和组织灌注率的内部对流功能。由于抛物线传热方程(PHTE)中没有考虑这些因素,因此结果表明,HPBTE 在预测温度和热骨坏死方面比 PHTE 更准确。因此,所提出的分析模型是一种计算温度的便捷工具,可以在提高工艺效率的同时避免热损伤。此外,它还具有控制手动或机器人钻孔程序以实现微创手术的能力。

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Effects of non-Fourier bioheat transfer on bone drilling temperature in orthopedic surgery: Theoretical and in vitro experimental investigation.骨科手术中基于非傅里叶热传递的钻骨温度效应:理论与体外实验研究。
Proc Inst Mech Eng H. 2022 Jun;236(6):811-824. doi: 10.1177/09544119221089122. Epub 2022 Apr 29.
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