PDF(Pubmed)
Abstract：
UNASSIGNED: This study aims to analyze the biomechanical characteristics of posterolateral plateau fractures fixed by a novel anatomical plate using finite element analysis.
UNASSIGNED: A three-dimensional digital model of the full length of right tibiofibula was obtained by CT scanning. A posterolateral tibial plateau fracture model was then created. The acquired fracture model was assembled with 4 groups of internal fixations: Group A, novel anatomical plate; Group B, straight buttress plate; Group C, oblique T-shaped locking plate; Group D, two lag screws. Axial loads of 500, 1,000 and 1,500 N perpendicular to the horizontal plane were used to simulate the stress on the lateral plateau of a 65 kg person standing, walking and fast running.
UNASSIGNED: Vertical displacements of the posterolateral fragments in each of the four groups gradually increased under loads from 500 N to 1,500 N. The maximum displacement of the fracture fragment in four groups were all located on the lateral side of the proximal part, and the displacement gradually decreased from the proximal part to the distal end. The maximum displacement values under the axial load of 1,500 N was in the following order: novel anatomical plate (1.2365 mm) < oblique T-shaped locking plate (1.314 mm) < two lag screws (1.3747 mm) < straight buttress plate (1.3932 mm). As the axial load increased, the stress value of the different internal fixation models gradually increased. The stress behavior of the same internal fixation model under different loads was similar. The maximum stress value under the axial load of 1,500 N was in the following order: novel anatomical plate (114.63 MPa) < oblique T-shaped locking plate (277.17 MPa) < two lag screws (236.75 MPa) < straight buttress plate (136.2 MPa).
UNASSIGNED: The patients with posterolateral plateau fractures fixed with a novel anatomical plate in standing, walking and fast running can achieve satisfactory biomechanical results, which lays the foundation for future applications. At the same time, clinical fracture types are often diverse and accompanied by damage to the soft tissue. Therefore, the ideal surgical approach and appropriate internal fixation must be selected based on the patient\'s injury condition.
UNASSIGNED: A three-dimensional digital model of the full length of right tibiofibula was obtained by CT scanning. A posterolateral tibial plateau fracture model was then created. The acquired fracture model was assembled with 4 groups of internal fixations: Group A, novel anatomical plate; Group B, straight buttress plate; Group C, oblique T-shaped locking plate; Group D, two lag screws. Axial loads of 500, 1,000 and 1,500 N perpendicular to the horizontal plane were used to simulate the stress on the lateral plateau of a 65 kg person standing, walking and fast running.
UNASSIGNED: Vertical displacements of the posterolateral fragments in each of the four groups gradually increased under loads from 500 N to 1,500 N. The maximum displacement of the fracture fragment in four groups were all located on the lateral side of the proximal part, and the displacement gradually decreased from the proximal part to the distal end. The maximum displacement values under the axial load of 1,500 N was in the following order: novel anatomical plate (1.2365 mm) < oblique T-shaped locking plate (1.314 mm) < two lag screws (1.3747 mm) < straight buttress plate (1.3932 mm). As the axial load increased, the stress value of the different internal fixation models gradually increased. The stress behavior of the same internal fixation model under different loads was similar. The maximum stress value under the axial load of 1,500 N was in the following order: novel anatomical plate (114.63 MPa) < oblique T-shaped locking plate (277.17 MPa) < two lag screws (236.75 MPa) < straight buttress plate (136.2 MPa).
UNASSIGNED: The patients with posterolateral plateau fractures fixed with a novel anatomical plate in standing, walking and fast running can achieve satisfactory biomechanical results, which lays the foundation for future applications. At the same time, clinical fracture types are often diverse and accompanied by damage to the soft tissue. Therefore, the ideal surgical approach and appropriate internal fixation must be selected based on the patient\'s injury condition.
摘要：
■本研究旨在使用有限元分析来分析通过新型解剖钢板固定的后外侧平台骨折的生物力学特征。
■通过CT扫描获得了右胫腓骨全长的三维数字模型。然后创建胫骨平台后外侧骨折模型。获得的骨折模型与4组内固定：A组，新型解剖钢板；B组，直支撑板；C组，斜T形锁定板；D组，两个方头螺钉。垂直于水平面的500、1,000和1,500N的轴向载荷用于模拟65公斤站立的人的侧向高原上的应力，步行和快速跑步。
■四组中每一组的后外侧碎片的垂直位移在从500N到1,500N的载荷下逐渐增加。四组中的骨折碎片的最大位移都位于近端部分的侧面，位移从近端到远端逐渐减小。1,500N轴向载荷下的最大位移值依次为：新型解剖板（1.2365mm）<斜T形锁定板（1.314mm）<两个拉力螺钉（1.3747mm）<直支撑板（1.3932mm）。随着轴向载荷的增加，不同内固定模型的应力值逐渐增加。同一内固定模型在不同载荷下的应力行为相似。1,500N轴向载荷下的最大应力值依次为：新型解剖板（114.63MPa）<斜T形锁定板（277.17MPa）<两个拉力螺钉（236.75MPa）<直支撑板（136.2MPa）。
■平台后外侧骨折患者用新型解剖钢板站立固定，步行和快速跑步可以达到令人满意的生物力学效果，为未来的应用奠定了基础。同时,临床骨折类型通常多种多样，并伴有软组织损伤。因此,必须根据患者的受伤情况选择理想的手术方式和适当的内固定。
■通过CT扫描获得了右胫腓骨全长的三维数字模型。然后创建胫骨平台后外侧骨折模型。获得的骨折模型与4组内固定：A组，新型解剖钢板；B组，直支撑板；C组，斜T形锁定板；D组，两个方头螺钉。垂直于水平面的500、1,000和1,500N的轴向载荷用于模拟65公斤站立的人的侧向高原上的应力，步行和快速跑步。
■四组中每一组的后外侧碎片的垂直位移在从500N到1,500N的载荷下逐渐增加。四组中的骨折碎片的最大位移都位于近端部分的侧面，位移从近端到远端逐渐减小。1,500N轴向载荷下的最大位移值依次为：新型解剖板（1.2365mm）<斜T形锁定板（1.314mm）<两个拉力螺钉（1.3747mm）<直支撑板（1.3932mm）。随着轴向载荷的增加，不同内固定模型的应力值逐渐增加。同一内固定模型在不同载荷下的应力行为相似。1,500N轴向载荷下的最大应力值依次为：新型解剖板（114.63MPa）<斜T形锁定板（277.17MPa）<两个拉力螺钉（236.75MPa）<直支撑板（136.2MPa）。
■平台后外侧骨折患者用新型解剖钢板站立固定，步行和快速跑步可以达到令人满意的生物力学效果，为未来的应用奠定了基础。同时,临床骨折类型通常多种多样，并伴有软组织损伤。因此,必须根据患者的受伤情况选择理想的手术方式和适当的内固定。
