足部有限元模型模拟碾压伤的生物力学分析
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摘要
背景:利用已建立的足部有限元数字模型,仿真模拟碾压工况下足骨的力学分布及损伤。目的:对足部三维有限元数字模型进行模拟碾压伤有限元力学分析,探讨有限元方法进行人足受力与损伤研究的新技术。方法:对1名健康女性志愿者足部(足尖至胫骨远端、腓骨远端在内的所有骨及关节)行螺旋CT扫描,将三维重建软件生成的足部三维数字模型导入有限元软件ANSYS13.0中处理生成有限元模型。对受力面加载100,200,500,1 000 N的压力,模拟压力缓慢作用于足背。经有限元力学计算步骤,对其进行模拟碾压伤有限元生物力学计算分析。结果与结论:(1)计算结果显示在碾压力作用下,随着压力的增加,足骨所产生的应力普遍升高,应力最大值均出现在足跟前内侧;(2)跖骨中应力主要集中在第一、二、三跖骨;(3)在跗骨中的应力主要集中在跗骨与跖骨、各跗骨之间的关节处;(4)随着压力的增加,应力逐渐向跗跖关节内侧集中,内侧楔骨应力较其余跗骨大;(5)经过模拟碾压伤情况下跗跖关节有限元应力分析,得出碾压伤情况下应力最大并集中部位,与临床跗跖关节损伤病人的骨折多发部位一致,间接证实了有限元模型的可靠性,可以为跗跖关节损伤研究提供数字化平台。
BACKGROUND: Mechanical distribution and damage of foot bones under rolling condition are simulated by using the established foot finite element digital model. OBJECTIVE: To simulate the crush injury by using the three-dimensional finite element model of foot, and to explore a new technique for studying the stress and damage of human foot by finite element method.METHODS: Foot(bones and joints from toe to distal tibia and distal fibula) of one female volunteer underwent CT scanning. The three-dimensional reconstructed digital model was imported into the ANSYS 13.0 software. The finite element mechanical analysis of simulating crush injury was carried out by setting 100, 200, 500 and 1 000 N of pressure, and solving the test calculation. RESULTS AND CONCLUSION:(1) Under rolling condition, the stress of foot bones was increased with pressure increasing, and the maximum stress occurred on the anteromedial heel.(2) Metatarsal stress mainly concentrated on the first, second and third metatarsuses.(3) Tarsal stress mainly concentrated on the joints between tarsus and metatarsus, and joints between tarsuses.(4) With the pressure increasing, the stress gradually concentrated on the medial side of tarsometatarsal joint. The stress of medial cuneiform bone was larger than the other tarsuses.(5) Finite element stress analysis of tarsometatarsal joint under simulated crush injury shows that the maximum stress and the site of the strain in the case of crush injury is consistent with that of the patients with clinical tarsal injury, and indirectly confirms the reliability of the finite element model, which can provide a digital platform for the study on tarsal and plantar joint damage.
BACKGROUND: Mechanical distribution and damage of foot bones under rolling condition are simulated by using the established foot finite element digital model. OBJECTIVE: To simulate the crush injury by using the three-dimensional finite element model of foot, and to explore a new technique for studying the stress and damage of human foot by finite element method.METHODS: Foot(bones and joints from toe to distal tibia and distal fibula) of one female volunteer underwent CT scanning. The three-dimensional reconstructed digital model was imported into the ANSYS 13.0 software. The finite element mechanical analysis of simulating crush injury was carried out by setting 100, 200, 500 and 1 000 N of pressure, and solving the test calculation. RESULTS AND CONCLUSION:(1) Under rolling condition, the stress of foot bones was increased with pressure increasing, and the maximum stress occurred on the anteromedial heel.(2) Metatarsal stress mainly concentrated on the first, second and third metatarsuses.(3) Tarsal stress mainly concentrated on the joints between tarsus and metatarsus, and joints between tarsuses.(4) With the pressure increasing, the stress gradually concentrated on the medial side of tarsometatarsal joint. The stress of medial cuneiform bone was larger than the other tarsuses.(5) Finite element stress analysis of tarsometatarsal joint under simulated crush injury shows that the maximum stress and the site of the strain in the case of crush injury is consistent with that of the patients with clinical tarsal injury, and indirectly confirms the reliability of the finite element model, which can provide a digital platform for the study on tarsal and plantar joint damage.
引文
[1]史洪飞.基于3种足弓参数的足弓与步幅特征的相关性研究[J].中国人民公安大学学报(自然科学版),2017;23(4):10-17.
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[3]夏迁洋.足弓与足跟痛关系的临床研究[J].中国医学工程,2014;22(8):101-107.
[4]任结根.足弓不稳定性是引起腰椎间盘突出症的重要原因之一[J].中国实用医药,2013,8(30):123-129.
[5]赵敦旭,陈旧性跖跗关节脱位的足弓重建[J].中国修复重建外科杂志.2009,23(7):886-887.
[6]徐世明,孙大炜,黄东.Lisfranc损伤的诊断和治疗研究进展[J].山东医药2018,58(7):111-114.
[7]宋谋珂,夏天,叶哲伟,等.跖跗关节复合体损伤的诊断与治疗方案的选择[J].中国骨与关节杂志.2013,2(7):382-385.
[8]俞平,邹国庆,单燕.跖跗关节隐匿性损伤三维CT的诊断价值[J].现代实用医学,2015,27(11):1514-1515.
[9]谢伟,马俊芳,王文斌,等.应用数字化断层融合技术诊断足骨骨折的价值[J].放射性实践.2015,30(4):381-384.
[10]张军胜,邵旭辉,张华文.螺旋CT与DR平片在显示足部骨折细微结构的对比分析[J].陕西医学杂志,2017,46(8):1018-1019.
[11]Herief TI,Mucci B,Greiss M.Lisfranc injury:how frequently does it get missed?And how can we improve?Injury.2007;38(7):856-860.
[12]温建民,孙卫东,成永忠,等.基于CT图像外翻足有限元模型的建立与临床意义[J].中国矫形外科杂志,2012,20(11):1026-1029.
[13]徐志庆,刘云鹏,华国军,等.前踝撞击征发生机制的生物力学有限元分析[J].中国矫形外科杂志,2017,25(14):1303-1307.
[14]Mc Cormaek AP,Niki H,Kiser P,et al.Two reconstructive techniques for flatfoot deformity comparing contact characteristics of the hindfoot joints.Foot Ankle Int.1998;19:452-461.
[15]Wagner UA,Sangeorzan BJ,Harrington RM,et al.Contact characteristics of the subtalar joint:load distribution between the anterior and posterior facets.J Orthop Res.1992;10:535-543.
[16]Pereira DS,Koval KJ,Resnick RB,et al.Tibiotalar contact area and Pressure distribution:the effect of mortise widening and syndesmosis fixation.Foot Ankle Int.1996;17:269-274.
[17]Cheung JT,Zhang M,Leung AK,et al.Three-dimensional finite element analysis of the foot during standing-a material sensitivity study.J Biomech.2005;38:1045-1054.
[18]Lakin RC,DeGnore LT,Pienkowski D.Contact mechanics of normal tarsometatarsal joints.J Bone joint surg Am.2001;83:520-528.
[19]郭国新,郭继涛,李伟,等.基于有限元模型的踝关节生物力学分析[J].中国组织工程研究,2012,16(17):3056-3060.
[20]郭国新,赵长义,曹雷,等.踝关节内翻的有限元力学分析[J].中国组织工程研究,2012,16(24):4801-4806.
[21]周宇宁,张宏,陈相春,等.建立足部三维有限元数字模型[J].中国组织工程研究,2015,19(5):662-666.
[22]Gaines RJ,Wright G,Stewart J.Injury to the tarsometatarsal joint complex during fixation of Lisfranc fracture dislocations:an anatomic study.J Trauma.2009;66(4):1125-1128.
[23]Myerson MS,Fisher RT,Burgess AR,et al.Fracture-dislocation of the tarsometatarsal joints and results correlated with pathology and treatment.Foot Ankle.1986;6:225-242.
[24]Hardcastle PH,Reschauer R,Kutscha-Lissberg E,et al.Injuries to the tarsometatarsal joint.Incidence,classification and treatment.J Bone Joint Surg Br.1982;64(3):349-356.
[25]Buzzard BM,Briggs PJ.Surgical Management of.Acute Tarsometatarsal Fracture.Clin Orthop Relat Res.1998;353:125-133.
[26]董骧,樊瑜波,张明.人体足部生物力学研究[J].生物医学工程学杂志,2002,19(1):148-153.
[27]袁刚,张木勋,王中琴,等.正常人足底压力分布及其影响因素分析[J].中华物理医学与康复杂志,2004,26(3):156-159.
[28]Desmond EA,Chou LB.Current concepts review:Lisfranc injuries.Foot Ankle Int.2006;27(8):653-660.
[29]Raikin SM,Elias I,Dheer S,et al.Prediction of midfoot instability in the subtle Lisfranc injury.Comparison of magnetic resonance imaging with intraoperative findings.JBone Joint Surg Am.2009;91(4):892-899.
[2]左建刚,王海雄,桑志成.外翻足足弓的研究现状和进展[J].中国矫形外科杂志,2015;23(15):1378-1382.
[3]夏迁洋.足弓与足跟痛关系的临床研究[J].中国医学工程,2014;22(8):101-107.
[4]任结根.足弓不稳定性是引起腰椎间盘突出症的重要原因之一[J].中国实用医药,2013,8(30):123-129.
[5]赵敦旭,陈旧性跖跗关节脱位的足弓重建[J].中国修复重建外科杂志.2009,23(7):886-887.
[6]徐世明,孙大炜,黄东.Lisfranc损伤的诊断和治疗研究进展[J].山东医药2018,58(7):111-114.
[7]宋谋珂,夏天,叶哲伟,等.跖跗关节复合体损伤的诊断与治疗方案的选择[J].中国骨与关节杂志.2013,2(7):382-385.
[8]俞平,邹国庆,单燕.跖跗关节隐匿性损伤三维CT的诊断价值[J].现代实用医学,2015,27(11):1514-1515.
[9]谢伟,马俊芳,王文斌,等.应用数字化断层融合技术诊断足骨骨折的价值[J].放射性实践.2015,30(4):381-384.
[10]张军胜,邵旭辉,张华文.螺旋CT与DR平片在显示足部骨折细微结构的对比分析[J].陕西医学杂志,2017,46(8):1018-1019.
[11]Herief TI,Mucci B,Greiss M.Lisfranc injury:how frequently does it get missed?And how can we improve?Injury.2007;38(7):856-860.
[12]温建民,孙卫东,成永忠,等.基于CT图像外翻足有限元模型的建立与临床意义[J].中国矫形外科杂志,2012,20(11):1026-1029.
[13]徐志庆,刘云鹏,华国军,等.前踝撞击征发生机制的生物力学有限元分析[J].中国矫形外科杂志,2017,25(14):1303-1307.
[14]Mc Cormaek AP,Niki H,Kiser P,et al.Two reconstructive techniques for flatfoot deformity comparing contact characteristics of the hindfoot joints.Foot Ankle Int.1998;19:452-461.
[15]Wagner UA,Sangeorzan BJ,Harrington RM,et al.Contact characteristics of the subtalar joint:load distribution between the anterior and posterior facets.J Orthop Res.1992;10:535-543.
[16]Pereira DS,Koval KJ,Resnick RB,et al.Tibiotalar contact area and Pressure distribution:the effect of mortise widening and syndesmosis fixation.Foot Ankle Int.1996;17:269-274.
[17]Cheung JT,Zhang M,Leung AK,et al.Three-dimensional finite element analysis of the foot during standing-a material sensitivity study.J Biomech.2005;38:1045-1054.
[18]Lakin RC,DeGnore LT,Pienkowski D.Contact mechanics of normal tarsometatarsal joints.J Bone joint surg Am.2001;83:520-528.
[19]郭国新,郭继涛,李伟,等.基于有限元模型的踝关节生物力学分析[J].中国组织工程研究,2012,16(17):3056-3060.
[20]郭国新,赵长义,曹雷,等.踝关节内翻的有限元力学分析[J].中国组织工程研究,2012,16(24):4801-4806.
[21]周宇宁,张宏,陈相春,等.建立足部三维有限元数字模型[J].中国组织工程研究,2015,19(5):662-666.
[22]Gaines RJ,Wright G,Stewart J.Injury to the tarsometatarsal joint complex during fixation of Lisfranc fracture dislocations:an anatomic study.J Trauma.2009;66(4):1125-1128.
[23]Myerson MS,Fisher RT,Burgess AR,et al.Fracture-dislocation of the tarsometatarsal joints and results correlated with pathology and treatment.Foot Ankle.1986;6:225-242.
[24]Hardcastle PH,Reschauer R,Kutscha-Lissberg E,et al.Injuries to the tarsometatarsal joint.Incidence,classification and treatment.J Bone Joint Surg Br.1982;64(3):349-356.
[25]Buzzard BM,Briggs PJ.Surgical Management of.Acute Tarsometatarsal Fracture.Clin Orthop Relat Res.1998;353:125-133.
[26]董骧,樊瑜波,张明.人体足部生物力学研究[J].生物医学工程学杂志,2002,19(1):148-153.
[27]袁刚,张木勋,王中琴,等.正常人足底压力分布及其影响因素分析[J].中华物理医学与康复杂志,2004,26(3):156-159.
[28]Desmond EA,Chou LB.Current concepts review:Lisfranc injuries.Foot Ankle Int.2006;27(8):653-660.
[29]Raikin SM,Elias I,Dheer S,et al.Prediction of midfoot instability in the subtle Lisfranc injury.Comparison of magnetic resonance imaging with intraoperative findings.JBone Joint Surg Am.2009;91(4):892-899.