Lei Dongwei, Lei Jingtao, Xu Haifei
School of Mechatronic Engineering and Automation, Shanghai University, Shanghai, China.
Comput Methods Biomech Biomed Engin. 2025 Jun;28(8):1319-1332. doi: 10.1080/10255842.2024.2324880. Epub 2024 Mar 4.
During robot-assisted reduction of pelvic fracture, blood vessels are susceptible to tensile and shear forces, making them prone to injury. Considering the impact of pelvic reduction on the risk of arterial injury, the biomechanical characteristics of arteries during the pelvic fracture reduction process are studied, and a refined coupled composite model of the damaged pelvic structure is established. Dynamic simulations of pelvic fracture reduction are conducted based on the planned reduction path. The simulation results show that during the reduction process, when the affected side is rotated, the stress and strain of the artery are maximum, particularly at the locations of the iliac common artery, internal iliac artery, and the superior gluteal artery arch endure significant stress and strain. After reduction, the maximum stress is observed in the right superior gluteal artery, and the maximum strain occurs at the intersection of the right iliac common artery. The stretch ratio of both the left and right iliac common arteries is considerable. Therefore, it can be concluded that the superior gluteal artery and the internal iliac artery are prone to injury, particularly the segment from the origin of the superior gluteal artery to its passage around the greater sciatic notch. After reduction, substantial traction on the iliac common artery, which makes it more susceptible to deformation, carries a risk of arterial rupture and aneurysm formation. This study provides a reference for planning the safe reduction path of pelvic fracture surgery and improving safety.
在机器人辅助骨盆骨折复位过程中，血管易受拉伸和剪切力作用，使其容易受伤。考虑到骨盆复位对动脉损伤风险的影响，研究了骨盆骨折复位过程中动脉的生物力学特性，并建立了受损骨盆结构的精细耦合复合模型。基于计划的复位路径对骨盆骨折复位进行动态模拟。模拟结果表明，在复位过程中，患侧旋转时动脉的应力和应变最大，特别是在髂总动脉、髂内动脉以及臀上动脉弓处承受显著的应力和应变。复位后，右侧臀上动脉观察到最大应力，最大应变出现在右侧髂总动脉的交叉处。左右髂总动脉的拉伸率都相当可观。因此，可以得出结论，臀上动脉和髂内动脉容易受伤，特别是从臀上动脉起源到其绕过坐骨大切迹的段。复位后，髂总动脉受到大量牵引，使其更容易变形，存在动脉破裂和动脉瘤形成的风险。本研究为规划骨盆骨折手术的安全复位路径和提高安全性提供了参考。
