摘要
目的比较袢钢板联合Nice结和锁骨钩钢板内固定治疗NeerIIB型锁骨远端骨折的生物力学特点。方法通过Mimics 21.0和Geomagic 2021软件构建锁骨远端骨折三维有限元模型,并分别与袢钢板联合Nice结和锁骨钩钢板装配,设置边界及载荷,比较两种内固定方式下锁骨骨折断端及固定物的位移及应力分布情况,分析不同内固定方式的稳定性。结果应力位移云图显示,袢钢板联合Nice结内固定系统的最大位移(4.28 mm)小于锁骨钩钢板组内固定系统(5.37 mm);袢钢板联合Nice结内固定系统最大应力(304.86 MPa)高于锁骨钩钢板内固定系统(134.50 MPa);骨折面最大位移两组相当(4.22 mm vs.4.25 mm);锁骨钩钢板内固定组骨折面最大应力(7.15 MPa)大于袢钢板联合Nice结内固定组(2.33 MPa)。结论两种内固定治疗锁骨远端骨折均能有效固定,与锁骨钩钢板相比,袢钢板联合Nice结内固定治疗锁骨远端骨折再骨折风险低,抵抗位移形变小,稳定性更高。但袢钢板联合Nice结内固定系统应力明显大于锁骨钩钢板组,长期高应力会有骨质破坏的风险。
Objective To compare the biomechanical characteristics of internal fixation with loop plate combined with Nice knot and clavicle hook plate for the treatment of NeerⅡB type distal clavicle fracture.Methods A three-dimensional finite element model of distal clavicle fracture was constructed using Mimics 21.0 and Geomagic 2021 software,and assembled with loop plate combined with Nice knot and clavicle hook plate respectively.Boundaries and loads were set to compare the displacement and stress distribution of the fractured end and fixation object of clavicle fracture between the two internal fixation methods,and analyze the stability of different internal fixation methods.Results According to the stress displacement cloud map,the maximum displacement of the loop plate combined with the Nice knot internal fixation system(4.28 mm)was smaller than that of the clavicle hook plate group internal fixation system(5.37 mm).The maximum stress of the loop plate combined with Nice knot internal fixation system(304.86 MPa)was significantly higher than that of the clavicle hook plate internal fixation system(134.50 MPa).The maximum displacement of the fracture surface was comparable between the two groups(4.22 mm vs.4.25 mm).The maximum stress on the fracture surface of the clavicle hook steel plate group(7.15 MPa)was significantly higher than that of the loop steel plate combined with Nice internal fixation group(2.33 MPa).Conclusion Both types of internal fixation can effectively fix distal clavicle fractures.Compared with clavicle hook plates,the combination of loop plates and Nice knots for internal fixation of distal clavicle fractures has a lower risk of re-fracture,less deformation in resisting displacement,and higher stability.However,the stress of the loop plate combined with Nice knot internal fixation system is significantly higher than that of the clavicle hook plate group,and long-term high stress may pose a risk of bone destruction.
作者
王章瑞
丁凡
王军海
王庆伟
叶正云
胡亮
Wang Zhangrui;Ding Fan;Wang Junhai;Wang Qingwei;Ye Zhengyun;Hu Liang(Medical School,Hubei Minzu University,Enshi 445000,China;Department of Orthopaedics,Jingmen Central Hospital Affiliated to Jingchu University of Technology,Jingmen 448000,China)
出处
《骨科》
2026年第1期50-54,共5页
ORTHOPAEDICS
关键词
锁骨远端骨折
袢钢板
Nice结
锁骨钩钢板
有限元分析
Distal clavicle fracture
Loop plate
Nice knot
Clavicle hook plate
Finite element analysis
