长骨类骨折内固定系统刚度和应力分布规律
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Stiffness and Stress Distribution of Internal Fixation System for Long Bone Fractures
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    摘要:

    目的 研究由断骨(含骨痂)和骨板组成的长骨类骨折内固定系统中各组成部分刚度和应力的分布规律,提出骨折内固定植入物抗弯刚度确定方法。方法 基于线性弯曲理论与复合梁理论,构建由断骨-骨板组成的股骨干骨折内固定系统的力学模型,以基于人造股骨CT数据的有限元模型进行验证,建立长骨类骨折内固定系统应力和刚度的关系式。结果 通过计算分析得到的断骨抗弯刚度随骨痂弹性模量变化3个阶段(缓慢增长-快速增长-平稳增长)与实际骨骼愈合过程中3个阶段的情况相符,证明理论计算方法的准确性;进一步得到断骨骨板组成的骨折内固定系统中性轴位置的变化规律,即提高(降低)骨板刚度可使中性轴位置向骨板中心轴靠近(远离);根据骨折愈合所需应力(0.72~0.80 MPa),得到骨板抗弯刚度的合理范围为0.99~4.20 kN·mm2。结论骨痂弹性模量为0.03~7.00 GPa时,断骨抗弯刚度快速上升,是骨桥的生成阶段;骨痂弹性模量为7 GPa以上时,骨痂趋于成熟。基于本文的股骨模型,当骨板厚度为3.6~6.0 mm,且断骨弹性模量为3.0~13.5 GPa时,可使整个断骨截面受到有效的力学刺激。本文的股骨骨折内固定系统在骨桥的生成阶段,接骨板抗弯刚度为0.99~4.20 kN·mm2时,有利于骨愈合。

    Abstract:

    Objective To study distributions of stiffness and stress of each component in internal fixation system for long bone fractures composed of fractured bones (including callus) and bone plates,and propose a method for determining bending stiffness of fracture internal fixation implants. Methods Based on the linear bending theory and composite beam theory, the mechanical model of femoral shaft internal fracture fixing system composed of fractured bones and bone plate was constructed and verified with the finite element model based on artificial femur CT data. The relationship between stress and stiffness of the internal fixation system for long bone fractures was established. Results The three stages (slow-rapid-steady growth) for variation of fractured bone bending stiffness with callus elastic modulus obtained by calculation and analysis were consistent with the three stages of actual bone healing process, which proved accuracy of the theoretical calculation method. Changing patterns for the neutral axis position of internal fracture fixing system composed of fractured bones and bone plate were further obtained, namely, the neutral axis position was close to (away from) the central axis of bone plate when stiffness of bone plate increased (decreased). According to the stress required for fracture healing (0.72-0.80 MPa), the reasonable range for bending stiffness of bone plate was 0.99-4.20 kN·mm2. Conclusions When elastic modulus of the callus was 0.037.00 GPa, bending stiffness of the fractured bones increased rapidly, which was at the stage of bone bridge formation. When elastic modulus of the callus was above 7 GPa, the callus tended to mature. Based on the femur model in this study, when thickness of bone plate was 3.6-6.0 mm and elastic modulus of fractured bones was 3.013.5 GPa, the entire fractured bone section could be effectively stimulated. In this study, when bending stiffness of bone plate was 0.99-4.20 kN·mm2 during the generation stage of bone bridge, it was conducive to bone healing.

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连晖,丁晓红,焦古月,段朋云.长骨类骨折内固定系统刚度和应力分布规律[J].医用生物力学,2022,37(4):604-611

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  • 收稿日期:2021-08-06
  • 最后修改日期:2021-10-12
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  • 在线发布日期: 2022-02-25
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