Department of Trauma Orthopedics Surgery, The 6th Hospital of Ningbo, Ningbo, People's Republic of China.
Department of Neurology, The Affiliated Hospital of Medical School of Ningbo University, Zhejiang, People's Republic of China.
Orthop Surg. 2024 Apr;16(4):976-983. doi: 10.1111/os.14012. Epub 2024 Mar 4.
Traditional internal fixation of calcaneus fractures, involving lateral L-shaped incisions and plate fixation, has disadvantages such as increased operative exposure, eccentric plate fixation, and complications. The aim of this study was to design a Spatial Weaving Intra-calcaneal Fixator System (SWIFS) for the treatment of complex calcaneal fractures and to compare its biomechanical properties with those of traditional calcaneal plates.
The computed tomography (CT) data of the normal adult calcaneus was used for modeling, and the largest trapezoidal column structure was cut and separated from the model and related parameters were measured. The SWIFS was designed within the target trapezoid, according to the characteristics of the fracture of the calcaneus. The Sanders model classification type IV calcaneal fracture was established in finite element software, and fixation with calcaneal plate and the SWIFS examined. Overall structural strength distribution and displacement in the two groups were compared.
The maximum 3D trapezoidal column in the calcaneus was constructed, and the dimensions were measured. The SWIFS and the corresponding guide device were successfully designed. In the one-legged erect position state, the SWIFS group exhibited a peak von Mises equivalent stress of 96.00 MPa, a maximum displacement of 0.31 mm, and a structural stiffness of 2258.06 N/mm. The conventional calcaneal plate showed a peak von Mises equivalent stress of 228.66 Mpa, a maximum displacement of 1.26 mm, and a structural stiffness of 555.56 N/mm. The SWIFS group exhibited a 75.40% decrease in displacement and a 306.45% increase in stiffness.
Compared with fixation by conventional calcaneal plate, the SWIFS provides better structural stability and effective stress distribution.
传统的跟骨骨折内固定术，涉及外侧 L 形切口和钢板固定，存在手术暴露增加、偏心钢板固定和并发症等缺点。本研究旨在设计一种空间编织跟骨内固定器系统（SWIFS）治疗复杂跟骨骨折，并与传统跟骨板的生物力学性能进行比较。
利用正常成人跟骨的计算机断层扫描（CT）数据进行建模，从模型中切割分离出最大的梯形柱状结构，并测量相关参数。根据跟骨骨折的特点，在目标梯形内设计 SWIFS。在有限元软件中建立 Sanders 模型分类 IV 型跟骨骨折模型，分别对跟骨板和 SWIFS 进行固定，比较两组的整体结构强度分布和位移。
构建了最大的跟骨三维梯形柱状结构，并测量了其尺寸。成功设计了 SWIFS 和相应的导向装置。在单腿直立位状态下，SWIFS 组的 von Mises 等效应力峰值为 96.00 MPa，最大位移为 0.31 mm，结构刚度为 2258.06 N/mm。传统跟骨板的 von Mises 等效应力峰值为 228.66 MPa，最大位移为 1.26 mm，结构刚度为 555.56 N/mm。SWIFS 组的位移减少了 75.40%，刚度增加了 306.45%。
与传统跟骨板固定相比，SWIFS 提供了更好的结构稳定性和有效的应力分布。
