中国组织工程研究 ›› 2025, Vol. 29 ›› Issue (33): 7080-7086.doi: 10.12307/2025.862

• 骨与关节生物力学 bone and joint biomechanics • 上一篇    下一篇

新型骶髂拉力钉的生物力学特征

梁  成1,2,3,4,卓川川1,张小刚4 ,王  冠1,段  可1,2,李  忠1,鲁晓波1,2,卓乃强1,2 ,靳忠民4,5   

  1. 西南医科大学附属医院,1骨科,3临床医学研究中心,四川省泸州市   646000;2四川省骨科置入器械研发及应用技术工程实验室,四川省泸州市   646000;4西南交通大学机械工程学院摩擦所,四川省成都市   610031;5利兹大学机械工程学院,英国利兹   LS2 9JT
  • 收稿日期:2024-09-03 接受日期:2024-11-16 出版日期:2025-11-28 发布日期:2025-04-12
  • 通讯作者: 张小刚,博士,副教授,西南交通大学机械工程学院摩擦所,四川省成都市 610031 卓乃强,博士,主任医师,西南医科大学附属医院骨科,四川省泸州市 646000;四川省骨科置入器械研发及应用技术工程实验室, 四川省泸州市 646000
  • 作者简介:梁成,男,1993年生,四川省泸州市人,汉族,2019年西南交通大学毕业,硕士,工程师,主要从事骨科生物力学研究。
  • 基金资助:
    国家自然科学基金面上项目 (52375207) ,项目负责人:张小刚;国家自然科学基金重点项目 (52035012),项目负责
    人:靳忠民;西南医科大学校级课题(2023ZD015),项目负责人:梁成;西南医科大学产学研项目(2022CXY03),项目负责人:鲁晓波

Biomechanical characteristics of a novel sacroiliac lag screw

Liang Cheng1, 2, 3, 4, Zhuo Chuanchuan1, Zhang Xiaogang4, Wang Guan1, Duan Ke1, 2, Li Zhong1, Lu Xiaobo1, 2, Zhuo Naiqiang1, 2, Jin Zhongmin4, 5   

  1. 1Department of Orthopedics, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China; 2Sichuan Provincial Laboratory of Orthopedic Implantation Device R&D and Application Technology Engineering, Luzhou 646000, Sichuan Province, China; 3Clinical Medicine Research Center, Affiliated Hospital of Southwest Medical University,  Luzhou 646000, Sichuan Province, China; 4Tribology Research Institute, School of Mechanical Engineering, Southwest Jiaotong University, Chengdu 610031, Sichuan Province, China; 5School of Mechanical Engineering, University of Leeds, Leeds LS2 9JT, UK
  • Received:2024-09-03 Accepted:2024-11-16 Online:2025-11-28 Published:2025-04-12
  • Contact: Zhang Xiaogang, PhD, Associate professor, Tribology Research Institute, School of Mechanical Engineering, Southwest Jiaotong University, Chengdu 610031, Sichuan Province, China Zhuo Naiqiang, MD, Chief physician, Department of Orthopedics, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China; Sichuan Provincial Laboratory of Orthopedic Implantation Device R&D and Application Technology Engineering, Luzhou 646000, Sichuan Province, China
  • About author:Liang Cheng, MS, Engineer, Department of Orthopedics, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China; Sichuan Provincial Laboratory of Orthopedic Implantation Device R&D and Application Technology Engineering, Luzhou 646000, Sichuan Province, China; Clinical Medicine Research Center, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China; Tribology Research Institute, School of Mechanical Engineering, Southwest Jiaotong University, Chengdu 610031, Sichuan Province, China
  • Supported by:
    National Natural Science Foundation of China, No. 52375207 (to ZXG); National Natural Science Foundation of China, No. 52035012 (to JZM); Southwest Medical University School-Level Project, No. 2023ZD015 (to LC); Southwest Medical University Industry-University-Research Project, No. 2022CXY03 (to LXB)

摘要:


文题释义:

骨钉抗拔出性能:骨钉依靠螺纹嵌入骨质带来把持效果,沿着某一固定方向将骨钉从骨质中拔出所需的最大力为骨钉的抗拔出力。一般把持骨质提供的牢固程度即为骨钉固定的牢固程度,以沿着骨钉轴向的抗拔出效果为代表。根据力学分析,骨钉各个方向的承载能力,竖直方向的抗拔出性能为最差性能。
骶髂关节损伤:骶髂关节是一个微动关节,依靠关节周围韧带和关节软骨连接,在承受冲击等负载时造成关节周围韧带或者软骨撕裂(或者关节周周骨折)导致骶髂关节连接强度降低的损伤。


背景:骨盆松质骨含量丰富,普通骶髂经皮拉力钉把持松质骨的能力有限,易固定失效,开发更能有效把持松质骨的拉力钉具有重要意义。

目的:采用生物力学测试和数值模型分析的方法探究新型骶髂拉力钉的力学性能,并分析抗拔出力数值模型的可靠性。
方法:根据新型骶髂拉力钉的工作原理建立力学模型,采用数值方法分析其抗拔出性能并用聚氨酯材料进行抗拔出力的力学测试验证,分析抗拔出力数值模型的可靠性。采用骨盆标本,分析正常站立姿态下新型骶髂拉力钉修复骶髂关节损伤的力学效果;并分析站立姿态下,不同骨盆固定模型的承载刚度。

结果与结论:①数值模型的计算值和实测值平均误差为13.19%,数值模型具有一定的有效性;②观察拉力钉拔出后的聚氨酯材料破坏情况,新型骶髂拉力钉组的破坏更小;③新型骶髂拉力钉抗拔出力的平均有效把持位移为(9.24±0.27) mm,显著大于普通骶髂经皮拉力钉的平均位移(1.71±0.57) mm;但普通骶髂经皮拉力的最大抗拔出力显著大于新型骶髂拉力钉;④新型骶髂拉力钉能有效修复骶髂关节损伤;⑤关于骶髂关节损伤修复后的刚度,1枚新型骶髂拉力钉与2枚普通骶髂经皮拉力钉效果相当;⑥此文建立的拉力钉理论模型具有一定有效性,能够参考并设计力学性能更优异的拉力钉;新型骶髂拉力钉具有更良好的固定性能,具有临床实用性。

https://orcid.org/0000-0001-7350-4355 (梁成) 

中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程

关键词: 新型骶髂拉力钉, 骶髂经皮拉力钉, 松质骨, 骶髂关节损伤, 生物力学

Abstract: BACKGROUND: The pelvis has abundant trabecular bone content, but the ability of conventional sacroiliac percutaneous fixation to control trabecular bone is limited, leading to fixation failure. Therefore, the development of devices that can more effectively control trabecular bone tension is of significant importance. 
OBJECTIVE: The mechanical properties of a novel sacroiliac tension screw were investigated using biomechanical testing and numerical modeling analysis, along with an assessment of the reliability of the pull-out force numerical model.  
METHODS: A mechanical model was established based on the working principle of the novel sacroiliac tension screw. Numerical methods were employed to analyze its pull-out performance, validated through mechanical testing with polyurethane material to assess the reliability of the pull-out force numerical model. Using pelvic specimens, the mechanical effectiveness of the novel sacroiliac tension screw in repairing sacroiliac joint injuries was analyzed under normal standing posture, along with an evaluation of the load stiffness of different pelvic models in the standing position. 
RESULTS AND CONCLUSION: (1) The average error between the computed values of the numerical model and the measured values was 13.19%, indicating a certain level of validity for the numerical model. (2) The damage to the polyurethane material after the extraction of the screw was less pronounced in the novel screw group. (3) The average effective holding displacement for the novel screw was approximately (9.24±0.27) mm, significantly greater than the average displacement of (1.71±0.57) mm observed with the lag screws. However, the maximum resistance to pullout for the lag screws was significantly higher than that for the novel screws. (4) The novel screw effectively repaired sacroiliac joint injuries. (5) The stiffness after repair of sacroiliac joint injuries was equivalent when using a single novel screw compared to using two lag screws. (6) These results prove that the theoretical model for the maximum resistance to pullout of the screws established in this study has a certain level of validity and can guide the design of them with improved mechanical performance. The novel sacroiliac spiral blade screw can effectively hold trabecular bone and has practical clinical utility.

Key words: novel sacroiliac lag screw, percutaneous sacroiliac lag screw, cancellous bone, sacroiliac joint injury, biomechanics

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