Three-dimensional finite element analysis of Kirschner nails and external fixation for Bennett fracture

doi:10.3969/j.issn.2095-4344.2017.03.012

Abstract

Abstract:

BACKGROUND: Klinefelter nails and external fixation were commonly used treatment methods for Bennett fracture, but study about biomechanics of two methods was little.

OBJECTIVE: To establish three-dimensional finite element models of Bennett fracture by Klinefelter nails and external fixation, and analyze its biomechanics.

METHODS: Three-dimensional models of Bennett fracture were established by small external fixation and Kirschner nail treatment. The Bennett fracture models established by small external fixation treatment were considered as model A. Bennett fracture models established by Kirschner nail treatment were considered as model B. 120 N load was applied to the first metacarpal X-axis direction. The X-direction displacement and total displacement of model A and model B, and the fracture fragments stress of model A and model B were observed.

RESULTS AND CONCLUSION: (1) In the X direction, the absolute values of maximum displacement and minimum displacement of model A at proximal fragment and distal fragment were less than model B; the maximum relative displacement, minimum relative displacement and average relative displacement of model A were less than model B. The differences of the average displacement of the proximal fracture fragment and the distal fragment, and the relative mean displacement in two models were statistically significant (P < 0.05). (2) In total displacement, absolute values of the maximum displacement and minimum displacement of model A at proximal fragment were less than model B; absolute values of the maximum displacement and minimum displacement of model A at distal fragment were less than model B; the maximum relative displacement, minimum relative displacement and average relative displacement of model A were less than model B. The differences of the average displacement of the proximal fracture fragment and the distal fragment, and the relative mean displacement in two models were statistically significant (P < 0.05). (3) The maximum stress value, a minimum stress value and the average stress values of fracture fragments of model A were significantly smaller than model B. The difference of the mean stress value in two models was statistically significant (P < 0.05). (4) These findings showed that the X-direction displacement and the total displacement were smaller, and the fracture fragments stress was uniform in small external fixation and Kirschner nail treatment for Bennett fracture, indicating that small external fixation for Bennett fracture has more advantages compared with Klinefelter nail.

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: Finite Element Analysis, Internal Fixators, External Fixators, Biomechanics, Tissue Engineering

CLC Number:

R318

Liu Jun, Liao Su-ping. Three-dimensional finite element analysis of Kirschner nails and external fixation for Bennett fracture[J]. Chinese Journal of Tissue Engineering Research, 2017, 21(3): 390-395.

Figures/Tables 3

References

[1] Middleton SD, McNiven N, Griffin EJ, et al.Long-term patient-reported outcomes following Bennett's fractures.Bone Joint J. 2015;97-B(7):1004-1006.

[2] Evans P, Pervaiz K.Sport-specific commentary on Bennett and metacarpal fractures in football.Hand Clin. 2012; 28(3):393-394.

[3] Clinkscales C.Sports-specific commentary on Bennett's fractures in professional basketball players: Bennettfractures and metacarpal fractures.Hand Clin. 2012;28(3):391-392.

[4] Mahmoud M, El Shafie S, Menorca RM, et al.Management of neglected Bennett fracture in manual laborers by tension fixation.J Hand Surg Am. 2014;39(9):1728-1733. doi: 10.1016/j.jhsa.2014.06.019.

[5] 冯晰旻,田兴辉,姜荃月.不同手术方式对Bennett骨折远期疗效的影响[J].中国骨与关节损伤杂志,2013,28(5):485-486.

[6] 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,2014,1(7): 158.

[7] Bennani A, Zizah S, Benabid M, et al.The intermetacarpal double pinning in the surgical treatment of Bennett fracture (report of 24 cases).Chir Main. 2012;31(3):157-162.

[8] 胥少汀,葛宝丰,徐印坎.实用骨科学[M].4版.北京:人民军医出版社,2014.

[9] Deml C, Smekal V, Kastenberger T, et al.Pressure distribution in carpometacarpal joint, due to step-off in operatively treated Bennett'sfractures.Injury. 2014;45(10):1574-1578.

[10] 刘德淮,庄小强,白宇,等.经皮克氏针固定微创治疗Bennett骨折[J].实用骨科杂志,2014,20(3):278-280.

[11] 王学磊,康志秋.两种手术方法治疗Bennett骨折[J].实用手外科杂志，2014,2(28):176-179.

[12] Pavi? R, Malovi? M.Operative treatment of Bennett's fracture. Coll Antropol. 2013;37(1):169-174.

[13] Leclère FM, Jenzer A, Hüsler R, et al.7-year follow-up after open reduction and internal screw fixation in Bennett fractures.Arch Orthop Trauma Surg. 2012;132(7):1045-1051.

[14] Zhang X, Shao X, Zhang Z, et al.Treatment of a Bennett fracture using tension band wiring.J Hand Surg Am. 2012; 37(3):427-433.

[15] 柳岩,牛杰,叶会跃,等.手法整复前臂石膏铁丝指夹板外固定治疗Bennett骨折[J].中医正骨,2013, 7(25):60-61．

[16] 梁献丹,朱玉辉,吕游,等.闭合复位经皮穿针微创治疗新鲜Bennett骨折23例[J] .中国现代药物应用,2014,22(8): 14-15.

[17] 汤样华,曾林如,徐灿达,等.微型外固定支架结合克氏针固定治疗Bennett骨折[J].中华手外科杂志,2012,28(6):372-373.

[18] 王武,曹鹏.闭合复位第一、二掌骨间克氏针固定治疗Bennett骨折[J].中华手外科杂志,2013,29(6):383-384.

[19] 王清义,张瑞云,关富龙,等.可吸收缝线钻孔环扎治疗Bennett骨折[J].中华手外科杂志,2011,27(5):319.

[20] 沈华,沈尊理,马杰,等.空心拉力螺钉治疗Bennett骨折的临床研究[J]．中华手外科杂志,2014,5(30): 365-367.

[21] 朱宏伟,张旭,李彦闯,等,钢丝张力带治疗Bennett骨折[J]．实用手外科杂志,2013,4(27): 364-365.

[22] 曹克奎,衣英豪,王相如,等. 闭合复位克氏针内固定治疗Bennett骨折[J]. 西南国防医药,2013,23(5):522-524.

[23] Elkins J, Marsh JL, Lujan T,et al.Motion Predicts Clinical Callus Formation: Construct-Specific Finite Element Analysis of Supracondylar Femoral Fractures.J Bone Joint Surg Am. 2016;98(4):276-284.

[24] Yu B, Chen WC, Lee PY,et al.Biomechanical comparison of conventional and anatomical calcaneal plates for the treatment of intraarticular calcaneal fractures - a finite element study.Comput Methods Biomech Biomed Engin. 2016:1-8.

[25] 支中正. 尺骨茎突骨折内固定对下尺桡关节稳定性影响的有限元分析[D].复旦大学,2013.

[26] 张浩,朱建民,马南,等. 腕关节有限元骨性建模及力学分析[J]. 江苏大学学报(医学版),2013,23(1):53-56.

[27] Mei ML, Chen YM, Li H,et al.Influence of the indirect restoration design on the fracture resistance: a finite element study. Biomed Eng Online. 2016;15(1):3.

[28] 顾松,刘天苹,沈尊理,等. 基于有限元的第5掌骨颈骨折钢板螺钉内固定的生物力学分析[J]. 现代生物医学进展,2015,15(21): 4056-4059.

[29] 谢世隆,方楚权,严瑾,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].中国医药指南,2014,12(18): 185-185.

[30] Harith H, Schmutz B, Malekani J,et al.Can we safely deform a plate to fit every bone? Population-based fit assessment and finiteelement deformation of a distal tibial plate.Med Eng Phys. 2016;38(3):280-285.

[31] Nigil Haroon N, Szabo E, Raboud JM, et al. Alterations of bone mineral density, bone microarchitecture and strength in patients with ankylosing spondylitis: a cross-sectional study using high-resolution peripheral quantitative computerized tomography and finite element analysis.Arthritis Res Ther. 2015;17(1):377.

[32] 陈延荣. 桡骨远端骨折畸形愈合后腕关节的生物力学变化[D].苏州大学,2013.

[33] Varga P, Zysset PK, Schefzig P, et al.A finite element analysis of two novel screw designs for scaphoid waist fractures. Med Eng Phys. 2016;38(2):131-139.

[34] Niort F, Godio-Raboutet Y, Torrents R, et al.Transmission of force to the hyoid bone during manual strangulation: Simulation using finiteelement numerical models.Forensic Sci Int. 2015;257:420-424.

[35] Noda M, Saegusa Y, Takahashi M,et al.Biomechanical Study Using the Finite Element Method of Internal Fixation in Pauwels Type III Vertical Femoral Neck Fractures.Arch Trauma Res. 2015;4(3):e23167.

[36] Liu XM, Pan CW, Wang GD, et al.Finite element analysis of the stability of combined plate internal fixation in posterior wall fracturesof acetabulum.Int J Clin Exp Med. 2015;8(8):13393- 13397.

[37] Synek A, Chevalier Y, Baumbach SF,et al.The influence of bone density and anisotropy in finite element models of distal radius fractureosteosynthesis: Evaluations and comparison to experiments.J Biomech. 2015;48(15):4116-4123.