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一种新型中空螺钉治疗髌骨下极骨折的新方法:有限元研究。

A novel technique of a new cannulated screw for treatment of inferior pole patellar fractures: a finite element study.

机构信息

Department of Orthopaedics, Shanghai Jiaotong University Affiliated Sixth People Hospital South Campus: Shanghai Fengxian Central Hospital, Shanghai, 201499, China.

出版信息

J Orthop Surg Res. 2023 Oct 24;18(1):795. doi: 10.1186/s13018-023-04299-y.

Abstract

OBJECTIVE

We invented a new cannulated screw with holes on the tail, which called Ding's screw. The goal of this study was to evaluate the biomechanical outcomes of this new screw with tension band wiring for the treatment of inferior pole patellar fractures in a finite element model.

METHODS

We conducted a finite element biomechanical study using two fixation methods: Ding's screw and tension band wiring (DSTBW) and cannulated screws and tension band wiring (CSTBW). Two methods were simulated to fix the inferior pole patellar fracture in a finite element model. The relative displacement and stress distribution were analyzed and compared.

RESULT

There were less displacement and stress distribution of DSTBW in different knee movement (30°, 60°, 90°, 120°) when compared to CSTBW. The highest value of displacement of the fracture and von Mises stress of the internal fixation happened in 120° knee movement in both groups. The highest displacement of the DSTBW was less than that of the CSTBW (1.92 mm to 2.12 mm). The highest value of the stress on the screws was 110.60 MPa in DSTBW group, and 132.90 MPa in CSTBW group. The highest value of the stress on the titanium cable was 38.51 MPa in DSTBW group, and 41.91 MPa in CSTBW group.

CONCLUSION

DSTBW fixation provides more stability than CSTBW fixation model in a finite element study.

摘要

目的

我们发明了一种带有尾部孔的新型空心螺钉,称为丁氏螺钉。本研究的目的是通过有限元模型评估这种新型螺钉与张力带钢丝固定治疗髌骨下极骨折的生物力学结果。

方法

我们进行了一项有限元生物力学研究,使用两种固定方法:丁氏螺钉和张力带钢丝固定(DSTBW)以及空心螺钉和张力带钢丝固定(CSTBW)。在有限元模型中模拟两种方法来固定髌骨下极骨折。分析和比较了相对位移和应力分布。

结果

与 CSTBW 相比,DSTBW 在不同膝关节运动(30°、60°、90°、120°)时的位移和应力分布较小。两组中,骨折的最大位移和内固定的 von Mises 应力均发生在 120°膝关节运动时。DSTBW 的最大位移小于 CSTBW(1.92mm 至 2.12mm)。DSTBW 组中螺钉上的最大应力为 110.60MPa,CSTBW 组中为 132.90MPa。DSTBW 组中钛缆上的最大应力为 38.51MPa,CSTBW 组中为 41.91MPa。

结论

在有限元研究中,DSTBW 固定比 CSTBW 固定模型提供了更高的稳定性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7da7/10594702/461957d921e0/13018_2023_4299_Fig1_HTML.jpg

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