锁定加压钢板固定骶骨不稳定骨折的三维有限元分析
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3-dimension finite elemental analysis on effects of locking compression plate for fixing unstable sacral fractures
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    摘要:

    目的探讨锁定加压钢板治疗骶骨不稳定骨折的生物力学性能,提供科学依据。方法应用三维有限元方法模拟骶骨Ⅰ、Ⅱ及Ⅲ区伴同侧耻骨上下支骨折的不稳定骨折,分别应用骶髂螺丝钉、骶骨棒、锁定加压钢板固定骶骨骨折,采用螺丝钉固定耻骨上支骨折,对模型腰5(L_5)椎体施以500 N的轴向应力,计算固定后骶骨及耻骨上支处的位移,并将加载下的骨应力分布同正常骨盆加载下骨的应力分布进行比较。结果三种固定中,骶髂螺丝钉的固定效果最佳,锁定加压钢板的固定效果同骶骨棒相似,三种方法固定后加载下应力分布均同正常骨盆相似。结论采用锁定加压钢板治疗骶骨不稳定骨折是一种可行的方法,尤其适用于伴有髂骨翼骨折的骶骨不稳定骨折或骶骨Ⅱ或Ⅲ区粉碎性骨折。

    Abstract:

    Objective To explore the biomechanical properties of locking compression plate for treating unstable sacral fractures and therefore to provide scientific foundation for clinic application.Methods 3-dimension finite element models were used to simulate normal pelvis and the unstable pelvis sufferedⅠsection ,Ⅱsection orⅢsection sacral fracture respectively and the fractures of pubis limbs.The unstable pelvises fixed with one screw for the fracture superior pubis limb and sacral screws,sacral bars or locking compression plate for the fracture of sacrum respectively were simulated.The mobility of the sacrum and pubis were calculated after giving 500N axial load on 5thlumbar vertebra and the bone stress distribution of the fixed unstable pelvis under axial load were compared with that of normal pelvis. Results Among the three fixing methods,the fixative effects of sacral screws are excellent and the effects of sacral bars and locking compression plate were similar.When the pelvis was under axial load ,the bone stress distribution of the unstable pelvis fixed with one of three methods were similar as that of normal pelvis.Conclusion It was a practical methods for treatment of the unstable sacral fractures fixed with locking compression plate,especially for the treatment of unstable sacral fractures,concomitant fracture of lilac ala or comminutedⅡsection orⅢsection sacral fracture.

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杜明奎,王秋根,张秋林,王辉,丁祖泉.锁定加压钢板固定骶骨不稳定骨折的三维有限元分析[J].医用生物力学,2007,22(1):94-98

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