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下颌髁突骨折两种内固定方式的有限元分析(对比研究)

Finite Element Analysis of Two Patterns of Internal Fixation of the Mandibular Subcondylar Fractures (Comparative Study).

作者信息

Shouman Hossam Abdelraouf, Metwally Kamal Ghamry, ELhadidi Yasser, Abd El Wahed Heba

机构信息

Department of Oral and Maxillofacial Surgery, Ain Shams University, Cairo, Egypt.

Faculty of Engineering, Beni-Suef University, Shark El-Nile, New Beni-Suef City, Egypt.

出版信息

J Maxillofac Oral Surg. 2025 Feb;24(1):123-129. doi: 10.1007/s12663-024-02420-0. Epub 2025 Jan 5.

Abstract

AIM

The aim of our study is to compare two plating techniques (delta plate and two miniplates) biomechanically, and to conclude which one is the more stable in the treatment of subcondylar fractures.

MATERIALS AND METHODS

3D model of human mandible was constructed on work bench solid works program and manipulated to mimic true subcondylar fracture with proximal and distal parts fully separated, three designs of plating techniques was constructed and wrapped on the mandible model, the final two models was exported to FEM software as solid models with masticatory muscles molded bilaterally in addition to contralateral molar clenching task, linear elastic solution was constructed for each model and results was assigned according to von misses stresses upon hardware, jaw bone and total model deformation in each configuration.

RESULT

Double plating 2.0 design showed optimal results compared to delta plate.

CONCLUSION

Double plating 2.0 design is the gold standard and the best method of fixation for the mandibular subcondylar fractures provided that available space is enough for the application of the two plates.

摘要

目的

本研究旨在对两种接骨板技术(三角接骨板和两块微型接骨板)进行生物力学比较,以确定在髁突下骨折治疗中哪种技术更稳定。

材料与方法

在SolidWorks程序工作台上构建人类下颌骨的三维模型,并进行操作以模拟真正的髁突下骨折,使近端和远端完全分离,构建三种接骨板技术设计并包裹在下颌骨模型上,最后将两个模型作为实体模型导出到有限元软件中,除了对侧磨牙咬紧任务外,双侧还模拟咀嚼肌,为每个模型构建线性弹性解,并根据每种配置下接骨板、颌骨的冯·米塞斯应力以及整个模型的变形来给出结果。

结果

与三角接骨板相比,双接骨板2.0设计显示出最佳结果。

结论

双接骨板2.0设计是下颌髁突下骨折固定的金标准和最佳方法,前提是有足够的空间来应用两块接骨板。

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本文引用的文献

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Finite element evaluation of three methods of stable fixation of condyle base fractures.髁突基部骨折三种稳定固定方法的有限元评估
Int J Oral Maxillofac Surg. 2014 Oct;43(10):1251-6. doi: 10.1016/j.ijom.2014.07.011. Epub 2014 Aug 11.
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Surgical management of a mandible subcondylar fracture.下颌骨髁突骨折的手术治疗
Arch Plast Surg. 2012 Jul;39(4):284-90. doi: 10.5999/aps.2012.39.4.284. Epub 2012 Jul 13.
8

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