不同牵引正畸方式治疗烧伤爪形手的生物力学分析
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国家自然科学基金项目(11372208,31870934,11972243)


Biomechanical Analysis on Different Traction Orthodontic Modes in the Treatment of Postburn Claw Hands
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    摘要:

    目的 研究烧伤爪形手畸形的形成及两种牵引正畸治疗中针对软组织的生物力学分析。 方法 建立包含皮 肤和瘢痕的手部有限元模型,对烧伤爪形手畸形的瘢痕挛缩-肌腱韧带挛缩-瘢痕切除并植皮-牵引正畸治疗全过程 进行数值模拟,对相关软组织进行生物力学分析,并对比两种牵引方式的优劣。 结果 瘢痕挛缩时,相关的屈肌和 伸肌都被拉伸;掌指关节处背侧韧带松弛,多数侧副韧带紧张。 手术治疗后,畸形有较大程度缓解;肌腱紧张或松 弛程度减小;紧张的侧副韧带松弛,挛缩的背侧韧带被拉伸。 牵引正畸治疗对手术治疗具有增益的效果。 对于烧 伤爪形手畸形,本文所设定的经过瘢痕松解后直接施加动态牵引的治疗方案安全有效,且对肌腱伸长有较好的促 进作用;从牵引效果来看,拉长式牵引方法较拮抗式牵引更具有优势。 结论 研究结果可以为临床介入和患者预 后的改善提供参考。

    Abstract:

    Objective To make biomechanical analysis on soft tissues in the formation of postburn claw hand deformity and during its two traction orthodontic treatments. Methods The hand model containing skin and scar was established, and the scar contracture-tendon and ligament contracture-scar excision with skin grafting- traction orthodontic treatment process for postburn claw hand deformity was simulated. Biomechanical analysis on relevant soft tissues was performed, and the advantages and disadvantages of the two traction modes were compared. Results The associated flexors and extensors were stretched when scar contracture occurred. The dorsolateral ligaments at the metacarpophalangeal ( MCP) joints were relaxed and most of the lateral collateral ligaments were tensed. After surgical treatment, the deformity was largely relieved. Tension or laxity of the tendons was reduced. The tensed lateral collateral ligaments were relaxed and the contracted dorsolateral ligaments were stretched. Traction orthodontic treatment was gainful for scar removal surgery. For postburn claw hand deformity, the treatment protocol of dynamic traction applied directly after scar release set up in this study was safe and effective, and had a better promotion effect on tendon elongation. In terms of traction effect, the elongated traction method showed more advantages than the antagonistic traction. Conclusions The research results may provide references for clinical interventions and prognosis improvement of patients.

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吕 营,郑清丽,侯春胜,安美文.不同牵引正畸方式治疗烧伤爪形手的生物力学分析[J].医用生物力学,2022,37(6):1088-1094

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  • 收稿日期:2022-01-20
  • 最后修改日期:2022-03-24
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  • 在线发布日期: 2022-12-24
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