Stress distribution on the humeroradial joint after ulnar osteotomy based on finite element analysis and I-Scan Stress Distribution Test system

doi:10.3969/j.issn.2095-4344.2017.35.017

Abstract

Abstract:

BACKGROUND: Ulnar osteotomy is firstly recommended for the therapy of Monteggia fracture in children. But, there is still a lack of biomechanical evidence to confirm its efficacy and safety.

OBJECTIVE: To analyze the stress distribution on the humeroradial joint after ulnar osteotomy and to provide evidence for confirming the angular size and mechanism for ulnar osteotomy.

METHODS: Nine elbow joints were subjected to different positions of physiological, posterior 15° and posterior 30° osteotomy, followed by loaded at different flexion angles in the neutral, pronation and supination positions, respectively, and then the detailed stress distribution and area in the humeroradial joint were obtained using I-Scan Stress Distribution Test system. One elbow joint was scanned by three-dimensional reconstruction CT and the three-dimensional finite element model was established by ANSYS software. The model was loaded with the same conditions based on the I-Scan Test system.

RESULTS AND CONCLUSION: (1) I-Scan Test system showed that the stress concentration area was in the medial side of humeroradial joint when elbow joint extended after the posterior osteotomy. Following the buckling angle of elbows increased, the area of stress concentration was changed to posterior and stress and contact area of humeroradial joint decreased correspondingly. An increase of stress and decrease of contact area appeared after posterior osteotomy compared with physiological osteotomy. (2) According to the finite element analysis, after posterior 15° and 30° osteotomy, pressure of humeroradial joint concentrated in medial-posterior region and the stress was increased. (3) To conclude, ulnar posterior 30° osteotomy is superior to 15° in reducing the incidence of radial head redislocation of Monteggia fracture, but may induce osteoarthritis of humeroradial joint.

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: Ulna, Osteotomy, Biomechanics, Finite Element Analysis, Tissue Engineering

CLC Number:

R318

He Qian-wei, Wei Li, Hu Ying-yu, Feng En-hui, Deng Wan-xi, Zhou Sheng-long, Chen Hai-yun. Stress distribution on the humeroradial joint after ulnar osteotomy based on finite element analysis and I-Scan Stress Distribution Test system[J]. Chinese Journal of Tissue Engineering Research, 2017, 21(35): 5679-5684.

Figures/Tables 3

2.1 I-Scan压力分布测试系统 2.1.1 生理角度截骨组在中立位状态下肱桡关节压力及接触面积随着肘关节屈曲角度增大而减少。前臂旋前状态下，当肘关节从0°屈曲至30°，60°，肱桡关节压力及接触面积逐渐减少，但屈曲90°时肱桡关节压力及接触面积均较30°及60°增加。在旋后状态下，当肘关节屈曲30°时肱桡关节压力及接触面积最小，当肘关节屈曲0°时肱桡关节压力及接触面积最大(表1)。中立位时应力集中区域分布较平均，随着屈曲角度增加，该区域转移至肱桡关节中央。旋前及旋后位时应力集中区域分别在内后侧及外侧(图3)。 2.1.2 后侧成角15°截骨组中立位状态下肱桡关节压力及接触面积随着肘关节屈曲角度增大而减少。在旋前位以及旋后位状态下，肘关节从0°屈曲至60°时，肱桡关节压力及接触面积仍随着肘关节屈曲角度增大而减少，但屈曲90°时压力及接触面积均较60°增加(表2)。应力集中区域从内侧或中央向内后方转移(图4)。 2.1.3 后侧成角30°截骨组在中立位、旋前位以及旋后位状态下肱桡关节压力及接触面积随着肘关节屈曲角度增大而减少(表3-5)。中立位时应力集中区域在中央，随着屈曲角度增加，逐渐转移至后侧；旋前位时，从内后方转移至后方；旋后位时，呈内后侧、中央、后侧分布(图5)。 2.2 有限元分析结果三维有限元分析结果显示，高应力集中区域及肱桡关节面应力随着肘关节屈伸运动而改变(表6，图6-8)。生理角度截骨组中，在肘关节伸直情况下，应力集中区在肱桡关节的侧方(中立位：外侧；旋前位：后侧；旋后位：内侧)，随着肘关节屈曲，应力集中区转移到关节中央，而且接触面积增大，肱桡关节应力减少。后侧成角15°，30°截骨组中，在肘关节伸直情况下，高应力集中区在肱桡关节内侧，随着肘关节屈曲，应力集中区转移至后侧，肱桡关节应力及接触面积相应减少。根据有限元分析的结果来看，应力分布形态与I-Scan压力分布测试系统传感器基本一致。"

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