Finite element analysis of three different fixation methods for distal tibial fracture

doi:10.3969/j.issn.2095-4344.1496

Abstract

Abstract:

BACKGROUND: The biomechanical properties of distal tibial intramedullary nails and locking plates are relatively rare.

OBJECTIVE: Three-dimensional finite element analysis was used to analyze internal fixation and bone under different stresses with three different fixation schemes.

METHODS: The digital technique was used to construct the distal tibial medial and lateral locking plate and and torsion force to simulate the force and displacement of the internal fixation and tibial fracture model under different stress conditions.

distal tibial nail model. The model combination was set according to the principle of internal fixation. The model of the medial plate fixation was model 1. The model of the lateral plate of the tibia was model 2. The fixed model of intramedullary nail was model 3. The three models received the loading mode of axial lateral force.

RESULTS AND CONCLUSION: Different fixation methods of distal tibial fractures had different characteristics of internal fixation when giving different directions of force. (1) When the axial force was given, the medial plate and fracture model of the distal tibia were uniformly stressed and the displacement was minimal. The stability was the best. There was no significant difference in the stability of the lateral tibial plate and the tibial bone marrow nail, but the lateral fixation of the distal tibia took more force. (2) When the internal fixation of the three forces bore similar strength, the fracture model of the intramedullary nail had to bear more strength; but the outer plate of the distal tibia had the largest displacement and poor stability. (3) When the model was torsion, the medial plate of the distal tibial fracture bore the greatest strength compared with other internal fixation methods. The distal plate fixation at the distal end of the humerus bore the minimum torsional force. In the intramedullary nail fixation method, the tibia itself shared more force. The displacement was largest, and its stability was worst. (4) It is concluded that the medial plate fixation of the distal tibial fracture is more stable than the distal lateral plate and intramedullary nail. The internal fixation and the tibia are more uniform and the stability is better. This study was approved by the Ethics Committee of Sichuan Provincial Orthopedic Hospital.

Key words: distal tibial fracture, three-dimensional reconstruction, finite element analysis, model, medial locking plate of the tibia, lateral locking plate of the tibia, intramedullary nail, axial force, lateral force, twisting force

CLC Number:

R447|R605|R683

Jia Junfeng, Tang Chengjie, Yue Jintao, Li Feng. Finite element analysis of three different fixation methods for distal tibial fracture[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(32): 5188-5194.

Figures/Tables 5

2.1 轴向加载各固定模型系统实验结果在模型1中，其内固定系统承担的承载力为95.54 MPa，见图4A，胫骨模型平均承载力为29.89 MPa，见图4B。而在模型2中，内固定系统承载力约为560.82 MPa，见图4C，胫骨模型平均应力为69.52 MPa，见图4D。在模型3中，内固定系统承载力约为320.24 MPa，见图4E，胫骨模型平均应力为94.70 MPa，见图4F。模型1，2，3的内固定受力3者差异有显著性意义(P < 0.05)，见表2；即给予轴向力时模型1的内固定受力最小，模型2的内固定受力最大。模型1，2，3差异有显著性意义(P < 0.05)，见表3；但模型2与模型3骨折模型受力差异无显著性意义(P > 0.05)，模型1，2，3的位移均值分别为：2.11，5.69，5.23 mm。3个模型位移值差异有显著性意义(P < 0.05)，见表4；即模型1位移较小，模型2的位移最大。 2.2 侧向弯曲加载各固定模型系统实验结果模型1内固定系统与胫骨骨折模型中，其内固定系统承担的承载力为72 MPa，见图5A，胫骨模型平均承载力为29.6 MPa，见图5B。而在模型2中，内固定系统承载力约为 114.63 MPa，见图5C，胫骨模型平均应力为32 MPa，见图5D。在模型3中，内固定系统承载力约为57.65 MPa，见图5E，胫骨模型平均应力为94.93 MPa，见图5F。模型1，2，3的内固定受力3者差异无显著性意义(P > 0.05)，见表5。模型1，2骨折模型无显著性意义(P > 0.05)；但模型3与模型1，2骨折模型差异有显著性意义 (P < 0.05)，见表6；模型3较模型1，2的胫骨骨折模型承担较多的压力；即模型1位移较小，模型2的位移最大。从模型1，2，3的位移分别为：0.1，0.48，0.19 mm。位移3者模型差异有显著性意义(P < 0.05)，见表7；模型2在给予侧向力时的位移最大。 "

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