中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (15): 3772-3779.doi: 10.12307/2026.329

• 骨与关节有限元分析Finite element analysis of bones and joints • 上一篇    下一篇

有限元分析弹性髓内钉治疗尺桡骨干双骨折不同进针点的力学差异

陈  伟1，杨玉亭2，王  艳3，聂伟志2   

  1. 1山东中医药大学 ，山东省济南市   250355；2山东省文登整骨医院，山东省威海市   264400；3长春中医药大学，吉林省长春市  130000
  • 接受日期:2025-05-13 出版日期:2026-05-28 发布日期:2025-11-05
  • 通讯作者: 聂伟志，博士，主任医师，山东省文登整骨医院，山东省威海市 264400
  • 作者简介:陈伟，男，1997年生，内蒙古自治区赤峰市人，汉族，山东中医药大学在读硕士，主要从事骨与关节损伤的微创治疗研究。
  • 基金资助:
    山东省中医药科技项目(Z-2023043)，项目负责人：聂伟志

Finite element analysis of mechanical differences between different entry points of elastic intramedullary nail in treatment of double fractures of radioulnar shaft

Chen Wei1, Yang Yuting2, Wang Yan3, Nie Weizhi2   

  1. 1Shandong University of Traditional Chinese Medicine, Jinan 250355, Shandong Province, China; 2Shandong Wending Orthopedic Hospital, Weihai 264400, Shandong Province, China; 3Changchun University of Chinese Medicine, Changchun 130000, Jilin Province, China
  • Accepted:2025-05-13 Online:2026-05-28 Published:2025-11-05
  • Contact: Nie Weizhi, MD, Chief physician, Shandong Wending Orthopedic Hospital, Weihai 264400, Shandong Province, China
  • About author:Chen Wei, Master candidate, Shandong University of Traditional Chinese Medicine, Jinan 250355, Shandong Province, China
  • Supported by:
    Shandong Province Traditional Chinese Medicine Science and Technology Project, No. Z-2023043 (to NWZ)

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摘要：

文题释义：

有限元分析：是一种基于数值计算方法的工程分析技术，核心是将复杂的连续体结构离散为有限数量的小单元，通过求解每个单元的力学行为，再整合得到整体结构的响应。有限元分析能够模拟复杂边界条件和材料特性，为精确分析骨骼、软组织的应力分布和变形特性提供精确的数据指导，为临床个性化治疗和3D打印医疗器械提供重要工具。
弹性髓内钉：是一种治疗骨折的内固定器械，具有微创、弹性固定的特点，其设计基于生物力学原理，通过插入骨髓腔内的弹性钉提供多点支撑，既能稳定骨折端，又允许适度微动，促进骨痂形成和骨折愈合。弹性髓内钉广泛应用于尺桡骨、股骨、胫骨等长骨骨折治疗，尤其适用于儿童骨骼生长活跃的特点，具有创伤小、恢复快、并发症少等优势，是骨科微创手术的重要工具之一。

摘要
背景：经皮弹性髓内钉治疗尺桡骨干双骨折桡骨的进针点主要有Lister结节和桡骨茎突两种选择，但针对上述两种进针点的对比未见报道。
目的：通过三维有限元技术分别建立尺桡骨干双骨折Lister结节进针和桡骨茎突进针三维有限元模型，模拟人体前臂正常运动，分析其生物力学稳定性及安全性。
方法：基于24岁正常成年男性尺桡骨CT 图像重建尺桡骨几何形态，应用有限元分析Mimics软件建立尺桡骨干双骨折Lister结节进针和桡骨茎突进针两种不同进针点模型，于Ansys软件中分别对模型施加旋转、屈曲、拉伸、压缩应力，分析其生物力学变化。
结果与结论：①通过三维有限元生物力学分析对比尺桡骨干双骨折两种进针点模型在不同应力下的最大位移、应力峰值及应力分布情况，发现Lister结节和桡骨茎突进针点均能有效控制断端移位，尤其在对抗屈曲应力上效果显著；②二者固定稳定性相近，桡骨茎突进针组对抗4种应力时最大位移值略小，但内固定应力更为集中；③两种模型都能有效分散压力，使骨骼应力均匀分布，骨骼及内固定峰值均集中于尺骨鹰嘴进针点，且桡骨茎突进针组在对抗屈曲应力时内固定应力峰值最大，有断钉或应力性骨折风险。


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: 弹性髓内钉, 尺桡骨干双骨折, 三维有限元, Lister结节, 桡骨茎突, 生物力学

Abstract: BACKGROUND: For the treatment of double fractures of the radioulnar shaft with percutaneous elastic intramedullary nails, the main entry points on the radius are the Lister tubercle and the radial styloid process. However, no reports have been found on the comparison between these two entry points.
OBJECTIVE: To establish three-dimensional finite element models of double fractures of the radioulnar shaft with entry points at the Lister tubercle and the radial styloid process respectively through three-dimensional finite element technology, simulate the normal movement of the human forearm, and analyze their biomechanical stability and safety.
METHODS: The geometric shapes of the radius and ulna were reconstructed based on the CT images of the radioulnar bones of a 24-year-old healthy adult male. The finite-element analysis software Mimics was used to establish two models with different entry points for double fractures of the radioulnar shaft, namely, the Lister tubercle entry-point model and the radial styloid process entry-point model. Four types of stresses, including rotation, flexion, tension, and compression, were applied to the models in Ansys software, and their biomechanical changes were analyzed.
RESULTS AND CONCLUSION: (1) Through three-dimensional finite element biomechanical analysis, by comparing the maximum displacement, stress peaks, and stress distributions of the two models with different entry points for double fractures of the radioulnar shaft under different stresses, it was found that both Lister tubercle and radial styloid process entry points could effectively control the displacement of the fracture ends, especially showing remarkable effects in resisting flexion stress. (2) The fixation stabilities of the two groups were similar. The maximum displacement value of the radial styloid process entry-point group was slightly smaller when resisting the four types of stresses, but the internal fixation stress was more concentrated. (3) Both models could effectively disperse the pressure, making the bone stress evenly distributed. The peak stresses of the bone and the internal fixation were concentrated at the entry point of the olecranon of the ulna. When resisting flexion stress, the internal fixation stress peak of the radial styloid process entry-point group was the largest, with a risk of nail breakage or stress fractures.

Key words: elastic intramedullary nail, double fractures of the radioulnar shaft, three-dimensional finite element, Lister's tubercle, styloid process of radius, biomechanics

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