不同固定方式对儿童肱骨近端不同高度骨折稳定性影响
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西安交通大学附属红会医院儿童骨病医院

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A finite element analysis to assess the stability of pediatric humeral proximal fractures fixed at different levels
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    摘要:

    目的 通过有限元方法比较不同固定方式对不同高度的儿童肱骨近端骨折的稳定性影响。方法 建立不同高度的儿童肱骨横行骨折模型,使用弹性髓内针及不同构型的克氏针构型进行固定,后导入ANSYS 2019中,模拟上肢重力以及前屈、后伸、内收、外展、内旋、外旋7种工况,分析肱骨远端最大位移、克氏针最大应力的平均值。结果 克氏针固定在P1、P2、P3、P4骨折面下的肱骨远端最大位移的平均值最小,分别为4针组1.728mm、3B组1.678mm、4针组1.821mm和4针组2.212mm结论 弹性髓内针固定在骨折面较低时优于3针固定,4枚克氏针则在所有高度优于弹性髓内针固定。

    Abstract:

    Objective The finite element method was used to compare the impact of various fixation methods on stability in pediatric humeral proximal fractures at different heights. Methods Different pediatric humeral transverse fracture models were created at varying heights and fixed using Elastic Stable Intramedullary Nailing(ESIN) and kirschner wire with different configurations. These models were imported into ANSYS 2019 to simulate the gravity of the upper limbs and the seven working conditions of anterior flexion, posterior extension, adduction, extension, internal rotation, and external rotation. The mean maximum displacement of the distal humerus and the maximum stress of the fixation were analyzed. Results The average maximum displacement of the distal end of the humerus was the smallest when Kocher's needle was fixed below the P1, P2, P3, and P4 fracture surfaces, respectively, for the 4-pin group (1.728mm), 3B group (1.678mm), 4-pin group (1.821mm), and 4-pin group (2.212mm) Conclusion. ESIN are preferable for fixing fractures at a lower position, while four kirschner wire are more effective than ESIN at all heights.

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  • 收稿日期:2023-04-26
  • 最后修改日期:2023-05-28
  • 录用日期:2023-06-02
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