Mechanical stability of external fixator versus metacarpal plate for Rolando fracture by three-dimensional finite element analysis

doi:10.3969/j.issn.2095-4344.0353

Abstract

Abstract:

BACKGROUND: The incidence of Rolando fracture is high, and there is no unified theory for the selection of external fixation and internal fixation plate.

OBJECTIVE: To compare the mechanical stability of the external fixator and metacarpal plate by establishing the three-dimensional (3D) finite element models, so as to provide a theoretical basis for the clinical treatment of Rolando fracture.

METHODS: One healthy adult volunteer was selected, and the wrist joint was scanned by CT and MRI. The data were imported into Mmics 10.0, and the 3D model of the first and the second metacarpal and trapezium was established. All data were imported into Geomagic studio 10 for editing, and then transferred into ANSYS 12.0. Micro external fixator, the micro metacarpal bone plate model and Rolando fracture type in the clinical treatment principle of the two kinds of fixation methods were constructed. Each model was built following appropriate unit type, and then given 100 N of vertical load in the first metacarpal fracture distal, and the maximum displacement was detected.

RESULTS AND CONCLUSION: (1) In the external fixation group, the relative displacement and total displacement of the maximum and minimum values of palm ulnar fracture end were 2.033, 0.201, 5.674, and 0.548 mm, were 2.537, 0.405, 4.479, 0.127 mm on the dorsolateral fracture end, respectively. In the plate group, the relative displacement and total displacement of the maximum and minimum values of palm ulnar fracture end were 0.385, 0.133, 0.595, 0.163 mm, were 0.278, 0.164, 0.501, 0.142 mm on the dorsal lateral fracture end, respectively. The differences were significant between two groups (P < 0.05). (2) To conclude, metacarpal plate is an ideal method for Rolando fracture.

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

Key words: Fractures, Bone, Internal Fixators, Finite Element Analysis, Tissue Engineering

CLC Number:

R318

Ai Deng-chao, Lu Yun. Mechanical stability of external fixator versus metacarpal plate for Rolando fracture by three-dimensional finite element analysis [J]. Chinese Journal of Tissue Engineering Research, 2018, 22(27): 4359-4363.

Figures/Tables 1

References

[1] 孟立民,苏啸天,张银光,等.微型外固定支架和克氏针治疗Bennett骨折的三维有限元分析[J].中国组织工程研究, 2012, 16(9): 92-93.

[2] 谢仁国,汤锦波,茅天,等.桡骨远端骨折合并腕关节韧带损伤的关节镜观察[J].中华手外科杂志, 2011,27(2):94-96.

[3] 杜宇,周哲.Rolando骨折成伤机制的法医学研究[J].刑事技术, 2013, 6):17-20.

[4] Kontakis GM, Katonis PG, Steriopoulos KA. Rolando's fracture treated by closed reduction and external fixation. Arch Orthop Trauma Surg.1998;117(1-2): 84-85..

[5] Carlsen BT, Moran SL. Thumb Trauma: Bennett fractures, Rolando fractures, and ulnar collateral ligament injuries. J Hand Surg Am.2009;34(5): 945-952.

[6] Simoneau TL, Kilbourn K, Spradley J, et al. An evidence-based stress management intervention for allogeneic hematopoietic stem cell transplant caregivers: development, feasibility and acceptability. Support Care Cancer. 2017;25(8):2515-2523.

[7] Perillo L, Jamilian A, Shafieyoon A, et al. Finite element analysis of miniscrew placement in mandibular alveolar bone with varied angulations. Eur J Orthod.2015;37(1):56-59.

[8] 胡勇,谢辉,杨述华.三维有限元分析在脊柱生物力学中应用研究[J].医用生物力学,2006, 21(3): 246-50.

[9] 解辉,李钧,陈波, 等.克氏针结合微型钢板治疗Rolando骨折[J].中国骨与关节损伤杂志,2005, 20(10): 666-666.

[10] 郑文源,陆芸,孟立民,等.螺钉、克氏针内固定治疗距骨颈骨折的三维有限元分析[J].山东医药, 2013,53(3): 7-9.

[11] 杨辰,陈山林,刘波,等.微型外固定架治疗闭合性第一掌骨基底关节内骨折[J].实用手外科杂志, 2013,27(4):315-318.

[12] 樊志强,徐永清,李晶,等.正常腕关节运动时腕中关节运动学在体研究[J].中国临床解剖学杂志, 2009,27(1):5-8.

[13] Constantinou-Deuretsbacher E, Mousavi M, Vécsei V. Adequate care of fractures near the base of the first metacarpal bone: clinical study of 160 patients. Osteo Trauma Care. 2003;11(02):51-55.

[14] 应有荣,应光华,朱让腾,等.“8”字扣压石膏条加石膏托固定治疗Rolando骨折[J].中医正骨, 2008,20(3):31-32.

[15] 杨小海. Rolando骨折的临床解剖及分型研究[D]. 苏州大学, 2006.

[16] [戴建辉,林海滨, 吴献伟,等. 可吸收螺钉内固定治疗Rolando骨折[J].中华创伤骨科杂志,2006, 8(8):797-798.

[17] 李建福,李起鸿,张信东.压应力促进骨折愈合的实验观察[J].中国矫形外科杂志,1997, 3:51-52,90.

[18] 苏佳灿,任可,张春才.应力对骨折愈合的影响及其作用机制[J]. 第二军医大学学报, 2001, 22(10):988-990.

[19] 奕央华,杨亚杰. Bennett、Rolando骨折的闭合复位内固定治疗[J].临床合理用药杂志, 2014,7(2): 158-159.

[20] Pennig D, Gausepohl T, Mader K, et al. The use of minimally invasive fixation in fractures of the hand-the minifixator concept. Injury.2000;31(1): 102-112.

[21] 李忠哲,郑炜,易传军,等.应用微型外固定架治疗第1掌骨基底部骨折[J].中华骨科杂志,2006,26(5): 289-293.

[22] 沙广钊,颜连启,王永东,等.微型外固定支架治疗Benneti、Rolando骨折[J].徐州医学院学报, 2007, 27(7):476-477.

[23] 陈山林,田光磊,田文,等.微型外固定系统在手部骨折中的应用[J]. 中华骨科杂志, 2004, 24(8): 469-473.

[24] 张允会,张旭阳,郭凯超, 等.T型掌指骨钢板联合拉力螺钉治疗Rolando骨折[J].实用手外科杂志,2017,1:113-114.

[25] 方磊,蔡俊丰,袁锋,等.应用微型钢板治疗三部分Rolando骨折[J].创伤外科杂志,2013,15(2):130-132.

[26] 吴一芃,徐永清,师继红,等. T 型掌指骨钢板联合克氏针固定治疗 Rolando 骨折[J].中华手外科杂志,2014,30(006): 416-418.

[27] 胡辉莹,钟世镇,聂晨阳.人体骨骼生物力学中有限元分析的研究进展[J].广东医学,2007, 28(9):1532-1534.

[28] 李智富,许扬滨.第一掌骨基底骨折的治疗进展[J].实用手外科杂志,2005,19(3):160-162.

[29] 裴国献,扈延龄.骨与关节损伤治疗中存在的问题与对策[J].创伤外科杂志,2007, 9(6):481-484.

[30] Milogevi? I, Sudji? V, Bumbasirevi? V, et al. Nonoperative treatment of fractures of the base of the first metacarpal bone--Bennett fracture. Acta Chir Iugosl. 2004;52(2): 67-71