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儿童外侧髁骨折克氏针固定矢状面有限元分析

Finite element analysis of Kirschner wire fixation for lateral condyle fracture in children in the sagittal plane.

作者信息

Bai Huanan, Lu Qingda, Liang Xiaoju, Wang Xiaoming, Yang Yating, Wang Huan, Wang Jiaju, Jie Qiang

机构信息

Pediatric Orthopaedic Hospital, Honghui Hospital, Xi'an Jiaotong University, Shaanxi, China.

School of Medicine, Medical College of Yan'an University, Yan'an, China.

出版信息

Front Pediatr. 2023 Jul 24;11:1210493. doi: 10.3389/fped.2023.1210493. eCollection 2023.

Abstract

OBJECTIVE

This study aims to find the optimal arrangement of the Kirschner wire (K-wire) in the sagittal plane for fixation of a pediatric lateral condylar humeral fracture (Milch type II) by using finite element analysis (FEA).

METHODS

A model of lateral condyle fracture in a 6-year-old boy was developed, and an coordinate system was established based on this model. The plane was defined as the sagittal plane to investigate the impact of the angle formed by the first and second K-wires on stability. Two configurations were studied for each angle: parallel and divergent. Evaluation indicators included the maximum displacement of the fracture fragment and the maximum von Mises stress in the pins and bone.

RESULTS

The model with a -60° angle showed the best performance in both evaluation indicators. The parallel and divergent pin configurations had different performances in each group. The displacement results for negative angles were similar, and this result was better than those for positive angles.

CONCLUSION

We successfully created a model of pediatric lateral condyle humerus fracture (Milch type II) and performed K-wire fixation with varying sagittal plane configurations, combined with FEA. Our findings demonstrate that the angle of -60° between the two pins in the sagittal plane provided the highest level of stability, with divergent configurations proving superior to parallel pinning at this angle.

摘要

目的

本研究旨在通过有限元分析(FEA)找出克氏针(K 针)在矢状面的最佳排列方式,用于小儿肱骨外侧髁骨折(米尔奇 II 型)的固定。

方法

建立一名 6 岁男孩的外侧髁骨折模型,并基于该模型建立一个坐标系。将 平面定义为矢状面,以研究第一根和第二根 K 针形成的角度对稳定性的影响。每个角度研究两种构型:平行和发散。评估指标包括骨折块的最大位移以及针和骨中的最大 von Mises 应力。

结果

-60°角的模型在两个评估指标中均表现最佳。每组中平行和发散针构型的表现不同。负角度的位移结果相似,且该结果优于正角度。

结论

我们成功创建了小儿肱骨外侧髁骨折(米尔奇 II 型)模型,并结合有限元分析对矢状面不同构型进行了 K 针固定。我们的研究结果表明,矢状面两根针之间-60°的角度提供了最高水平的稳定性,在此角度下,发散构型优于平行固定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00d3/10405918/a54887211bbe/fped-11-1210493-g001.jpg

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