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使用史赛克VariAx 2系统进行腓骨骨折固定的生物力学行为:下肢负荷分布的有限元分析

Biomechanical behavior of fibula fracture fixation using the Stryker VariAx 2 system: A finite element analysis of lower limb load distribution.

作者信息

Filardi V

机构信息

D.A. Scientific Research and Internationalization, University of Messina, Via Consolato Del Mare 41, 98121, Messina, Italy.

出版信息

J Orthop. 2025 Mar 17;69:53-60. doi: 10.1016/j.jor.2025.03.039. eCollection 2025 Nov.

Abstract

AIMS

In this study, we used finite element analysis to evaluate the mechanical behavior of the lower extremity under three conditions: an intact fibula, a fractured fibula without fixation, and a fractured fibula stabilized using the Stryker VariAx 2 One-Third Tubular Plating System.

METHODS

Three-dimensional solid models incorporating detailed representations of bones, ligaments, and tendons were developed from CT and MRI data. Loading conditions were imposed simulating an axial compressive load of 700 N applied to the upper extremity of the resected femur and a torsional load of 6000 Nmm applied to the proximal femur, and a fixed constraint was imposed on the foot, simulating physiological conditions encountered during gait.

RESULTS

indicated that the absence of the fibula leads to significant increases in stress and angular displacement across key anatomical regions, including the tibia, femur, patella, and foot, underscoring the fibula's role in load sharing. Although reintroducing a fibular implant partially ameliorates these effects, the implant itself exhibits elevated stress compared to a natural fibula.

CONCLUSION

These findings highlight the need for careful preoperative planning and individualized treatment strategies in fibula fracture management, while also informing future improvements in implant design.

摘要

目的

在本研究中,我们使用有限元分析来评估下肢在三种情况下的力学行为:完整腓骨、未固定的腓骨骨折以及使用史赛克VariAx 2三分之一管状钢板系统固定的腓骨骨折。

方法

根据CT和MRI数据建立了包含骨骼、韧带和肌腱详细表征的三维实体模型。施加加载条件,模拟对切除的股骨上端施加700 N的轴向压缩载荷以及对股骨近端施加6000 Nmm的扭转载荷,并对足部施加固定约束,模拟步态中遇到的生理条件。

结果

表明腓骨缺失会导致关键解剖区域(包括胫骨、股骨、髌骨和足部)的应力和角位移显著增加,突出了腓骨在分担负荷中的作用。尽管重新植入腓骨植入物可部分改善这些影响,但与天然腓骨相比,植入物本身的应力会升高。

结论

这些发现强调了在腓骨骨折治疗中进行仔细术前规划和个体化治疗策略的必要性,同时也为植入物设计的未来改进提供了参考。

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本文引用的文献

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World J Orthop. 2021 May 18;12(5):254-269. doi: 10.5312/wjo.v12.i5.254.
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