Analysis of the stress and displacement distribution of inferior tibiofibular syndesmosis injuries repaired with screw fixation: a finite element study.
Analysis of the stress and displacement distribution of inferior tibiofibular syndesmosis injuries repaired with screw fixation: a finite element study.
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螺钉固定修复下胫腓联合损伤的应力和位移分布分析：有限元研究
DOI：
10.1371/journal.pone.0080236
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Pei G
中科院分区：
文献类型：
--
作者：
Liu Q;Zhang K;Zhuang Y;Li Z;Yu B;Pei G
背景对关节粘连损伤的研究主要集中在身体模型。然而，他们无法获得关于各种组织的应力和位移分布的准确数据，而且很难比较模型。用有限元方法研究了下胫腓联合损伤(ITSI)和踝关节螺钉固定对踝关节生物力学的影响。方法/主要发现利用计算机断层扫描(CT)图像建立了一个健康的踝关节复合体的三维模型。我们在损伤的胫距关节联合上方2.5 cm的平面上建立了ITSI和螺钉固定的模型。分别在中立位、单足站立和踝关节内、外旋转三种状态下施加模拟载荷。ITSI减少了距骨和腓骨之间的接触力，帮助关节周围的踝关节韧带承受更多的负荷运动，并增加了胫骨和腓骨下端的移位幅度。ITSI联合螺钉固定减少了所有关节的接触力，减少了胫骨和腓骨下端的移位幅度，并增加了小腿骨间膜应力。结论/意义严重的关节突伤会导致踝关节的应力和位移分布改变为多向踝关节不稳定，应采用内固定治疗。虽然横联韧带螺钉有效地稳定了关节韧带的分离，但它也改变了踝关节周围的应力分布，减小了关节的活动范围。因此，不应长时间进行固定，因为它在生理上不适合踝关节。
Background Studies of syndesmosis injuries have concentrated on cadaver models. However, they are unable to obtain exact data regarding the stress and displacement distribution of various tissues, and it is difficult to compare models. We investigated the biomechanical effects of inferior tibiofibular syndesmosis injuries (ITSIs) and screw fixation on the ankle using the finite element (FE) method. Methodology/Principal Findings A three-dimensional model of a healthy ankle complex was developed using computed tomography (CT) images. We established models of an ITSI and of screw fixation at the plane 2.5 cm above and parallel to the tibiotalar joint surface of the injured syndesmosis. Simulated loads were applied under three conditions: neutral position with single-foot standing and internal and external rotation of the ankle. ITSI reduced contact forces between the talus and fibula, helped periarticular ankle ligaments withstand more load-resisting movement, and increased the magnitude of displacement at the lower extreme of the tibia and fibula. ITSI fixation with a syndesmotic screw reduced contact forces in all joints, decreased the magnitude of displacement at the lower extreme of the tibia and fibula, and increased crural interosseous membrane stress. Conclusions/significance Severe syndesmosis injuries cause stress and displacement distribution of the ankle to change multidirectional ankle instability and should be treated by internal fixation. Though the transverse syndesmotic screw effectively stabilizes syndesmotic diastasis, it also changes stress distribution around the ankle and decreases the joint's range of motion (ROM). Therefore, fixation should not be performed for a long period of time because it is not physiologically suitable for the ankle joint.
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DOI：
10.1177/107110078901000308
发表时间：
1989-12-01
期刊：
FOOT & ANKLE
影响因子：
--
作者：
HARPER, MC;KELLER, TS
通讯作者：
KELLER, TS
影响因子：
4.8
作者：
BOYTIM, MJ;FISCHER, DA;NEUMANN, L
通讯作者：
NEUMANN, L
DOI：
10.2106/00004623-198971100-00014
发表时间：
1989-12-01
影响因子：
5.3
作者：
BODEN, SD;LABROPOULOS, PA;HURWITZ, SR
通讯作者：
HURWITZ, SR
影响因子：
5.3
作者：
Rausch MK;Kuhl E
通讯作者：
Kuhl E
踝关节胫腓韧带和胫距韧带的生物力学评估
影响因子：
2.7
作者：
Beumer, A;van Hemert, WLW;Belkoff, SM
通讯作者：
Belkoff, SM