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镁质钢板和螺钉固定系统在LeFort I型截骨术中的生物力学稳定性：三维有限元分析

Biomechanical stability of magnesium plate and screw fixation systems in LeFort I osteotomy: a three-dimensional finite element analysis.

作者信息

Cho Su-Min, Yang Byoung-Eun, Kim Won-Hyeon, Park Sang-Yoon, On Sung-Woon, Lee Jong-Ho, Byun Soo-Hwan

机构信息

Department of Prosthodontics, Hallym University Sacred Heart Hospital, Anyang, 14066, Republic of Korea.

Graduate School of Clinical Dentistry, Hallym University, Chuncheon, 24252, Republic of Korea.

出版信息

Maxillofac Plast Reconstr Surg. 2024 Dec 18;46(1):40. doi: 10.1186/s40902-024-00451-8.

DOI:10.1186/s40902-024-00451-8
PMID:39692988
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11655716/
Abstract

BACKGROUND

Titanium (Ti-6Al-4 V) is used for fixation in LeFort I osteotomy, a procedure for treating midface deformities. This study assessed the biomechanical stabilities of two Mg alloys (WE43 and ZK60) as biodegradable alternatives and compared them against Ti using finite element analyses. The LeFort I osteotomy procedure was simulated, and various plate and screw configurations were tested. The maximum principal and peak von Mises stresses in the metal plates and bone screws were measured under four load conditions, and the stability was evaluated.

RESULTS

The holes in the Mg screws, as compared with the Ti counterparts, exhibited higher and lower stress levels in the cortical and cancellous bones, respectively. The Mg screws also exhibited a higher fracture risk. The ZK60 plate, as compared with the Ti and WE43 plates, exhibited a lower fracture risk under all load conditions. ZK60 exhibited higher biomechanical stability in terms of maintaining the gap between osteotomy surfaces and lower fracture risk; the osteotomy surfaces with Ti im-plants underwent bone impaction, resulting in gap closure.

CONCLUSIONS

Although the Mg implants exhibited better stress distribution, their screw strength requires improvement. Appropriate improvements can promote the use of Mg alloys in bone fixation applications.

摘要

背景

钛（Ti-6Al-4V）用于勒福Ⅰ型截骨术的固定，该手术用于治疗面中部畸形。本研究使用有限元分析评估了两种镁合金（WE43和ZK60）作为可生物降解替代品的生物力学稳定性，并将它们与钛进行比较。模拟了勒福Ⅰ型截骨术过程，并测试了各种钢板和螺钉配置。在四种载荷条件下测量金属板和骨螺钉中的最大主应力和峰值冯·米塞斯应力，并评估稳定性。

结果

与钛螺钉相比，镁螺钉的孔在皮质骨和松质骨中分别表现出更高和更低的应力水平。镁螺钉也表现出更高的骨折风险。与钛板和WE43板相比，ZK60板在所有载荷条件下均表现出更低的骨折风险。ZK60在维持截骨面之间的间隙方面表现出更高的生物力学稳定性，且骨折风险更低；植入钛植入物的截骨面发生骨撞击，导致间隙闭合。

结论

尽管镁植入物表现出更好的应力分布，但其螺钉强度需要改进。适当的改进可以促进镁合金在骨固定应用中的使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d0f/11655716/99a7a913533c/40902_2024_451_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d0f/11655716/a5155c774637/40902_2024_451_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d0f/11655716/a9fea0ff98ed/40902_2024_451_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d0f/11655716/484004d63d57/40902_2024_451_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d0f/11655716/ac3001001d8c/40902_2024_451_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d0f/11655716/1dd344a3f4c8/40902_2024_451_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d0f/11655716/517af3378ac4/40902_2024_451_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d0f/11655716/752ec1a371c3/40902_2024_451_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d0f/11655716/99a7a913533c/40902_2024_451_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d0f/11655716/a5155c774637/40902_2024_451_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d0f/11655716/a9fea0ff98ed/40902_2024_451_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d0f/11655716/484004d63d57/40902_2024_451_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d0f/11655716/ac3001001d8c/40902_2024_451_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d0f/11655716/1dd344a3f4c8/40902_2024_451_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d0f/11655716/517af3378ac4/40902_2024_451_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d0f/11655716/752ec1a371c3/40902_2024_451_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d0f/11655716/99a7a913533c/40902_2024_451_Fig8_HTML.jpg

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