北京生物醫(yī)學(xué)工程

利用有限元分析技術(shù)探討后踝骨折的治療方案

Optimization for Posterior Malleolus Fracture Treatment with Finite Element Analysis Method

作者：劉志強(qiáng) 都承斐楊茂偉

單位：中國(guó)醫(yī)科大學(xué)附屬第一醫(yī)院（沈陽(yáng)110001）

關(guān)鍵詞：踝關(guān)節(jié)；有限元分析；骨折面積；應(yīng)力分析

分類號(hào)：

出版年·卷·期（頁(yè)碼）：2011·30·5（467-470）

摘要：

目的通過踝關(guān)節(jié)三維有限元模型，研究靜止站立位后踝骨折后脛距關(guān)節(jié)面的應(yīng)力變化及位移趨勢(shì)，為
后踝骨折的治療提供理論依據(jù)。方法以一套正常人體站立位踝關(guān)節(jié)CT圖像為原始數(shù)據(jù)，應(yīng)用有限元建
模技術(shù)，建立帶有關(guān)節(jié)軟骨的踝關(guān)節(jié)三維有限元模型，對(duì)模型的有效性進(jìn)行驗(yàn)證。通過對(duì)后踝關(guān)節(jié)面進(jìn)
行分區(qū)、切割，模擬計(jì)算后踝不同骨折范圍條件下施加正常應(yīng)力時(shí)的關(guān)節(jié)軟骨接觸面積、最大接觸應(yīng)力
、平均接觸應(yīng)力、最大位移等參數(shù)。結(jié)果隨著骨折范圍的增加，脛骨軟骨接觸面積呈逐漸減小趨勢(shì)，
脛骨軟骨的平均接觸應(yīng)力值逐漸增大，脛骨相對(duì)位移增加。脛距關(guān)節(jié)的應(yīng)力區(qū)主要集中在踝穴的外側(cè)及
前外側(cè)，當(dāng)后踝骨折面積超過1/3時(shí)，關(guān)節(jié)負(fù)重區(qū)面積明顯縮小，關(guān)節(jié)位移趨勢(shì)增加。結(jié)論后踝骨折面
積超過1/3時(shí)，關(guān)節(jié)接觸面積明顯減小，應(yīng)力變化明顯增加，關(guān)節(jié)位移趨勢(shì)增加，預(yù)后不佳，具有手術(shù)復(fù)
位固定的指征。

Objective To provide the theoretical basis for the treatment of posterior
malleolus fracture by investigate the stress variation and displacement trend of tibial
astragaloid joint at still stand position with 3D finite element model of ankle，which has
suffered the posterior malleolus fracture.Methods The 3D finite element model of ankle with
cartilage was established with a set of the normal standing human ankle CT images as
primitive data.The model was validated and after the CT image of tibial astragaloid joint
was zoned and cut into different range fracture in normal stress loading cases，we
simulated the articular cartilage contact area，max contact press，mean contact press and
max displacement.Results With the increase of the fracture area，the contact area of tibial
articular cartilage decreased，the contact stress of the joint and relative displacement
increased gradually.As the fracture area exceeded third，the joint load area decreased
obviously and the joint displacement trend increased.Conclusions As the fracture area is
more than third，the articular cartilage contact area and contact stress change obviously，
which results in bad prognosis and in need of surgical operation.

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