旋前-外旋型三踝骨折逆移位手法复位有限元分析

目的 结合临床经验应用有限元方法探讨旋前-外旋型三踝骨折逆移位手法复位的可行性。方法 基于CT影像及骨骼韧带等组织解剖特点、材料参数，构建国人年轻男性筋骨完整的正常踝关节模型；根据旋前-外旋型三踝骨折的相关特点，在恰当的位置进行截骨造模，建立筋骨结构完整的旋前-外旋型三踝骨折有限元模型；在有限元骨折模型上进行逆移位手法复位力学加载。结果 通过位移加载，所建旋前-外旋型三踝骨折有限元模型得到了有效的复位。结论 通过对逆移位手法复位旋前-外旋型三踝骨折进行有限元分析，在临床经验的基础上进一步证明了逆移位手法复位方法具有一定的可行性、有效性及科学性。
Objective To investigate the feasibility of manual reduction with inverse shift for pronation-extorsion trimalleolar fracture by applying the finite element method combined with clinical experience. Methods Based on CT images and anatomical features of bone, ligaments and other tissues as well as material parameters, a normal ankle model with completed muscles and bones for a Chinese young male was established. According to the related characteristics of the pronation-extorsion trimalleolar fractures, fracture was simulated in the proper position to make osteotomy model. The finite element model of pronation-extorsion trimalleolar fractures was thus established and then applied with mechanical loading to simulate manual reduction with inverse shift. Results The established finite element model of pronation-extorsion trimalleolar fractures was effectively restored by the displacement loading. Conclusions The finite element analysis on pronation-extorsion trimalleolar fractures by inverse shift maneuver could further prove the feasibility, effectiveness and scientificity of manual reduction with inverse shift based on clinical experience.