微创外翻手术中不同螺钉固定方法的生物力学比较研究：有限元分析

IF 1.9 3区医学 Q2 ORTHOPEDICS

Foot and Ankle Surgery Pub Date : 2024-09-10 DOI:10.1016/j.fas.2024.09.001

T L Lewis,H Mansur,G F Ferreira,M V P Filho,L R Battaglion,R Zambelli,R Ray,G A Nunes

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引用次数: 0

摘要

背景尽管评估每种结构稳定性和强度的生物力学数据有限，但用于微创外翻（HV）畸形的螺钉配置却各不相同。我们旨在使用有限元分析（FEA）比较微创 HV 手术中各种螺钉配置的强度。测试了使用一根或两根双皮质螺钉或髓内螺钉的五种螺钉配置。应力分析考虑了每种螺钉配置的截骨位移、最大和最小主应力以及植入物和骨的冯米斯应力。结果使用两根螺钉（一根双皮质螺钉和一根髓内螺钉）进行固定，在两种加载条件下，截骨位移、最小和最大总应力以及骨和螺钉的等效冯米斯应力的值都是最低的。结论在对中度 HV 进行微创手术时，最佳配置是一颗双皮质螺钉和一颗髓内螺钉。

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Comparative biomechanical study of different screw fixation methods for minimally invasive hallux valgus surgery: A finite element analysis.

BACKGROUND There are different screw configurations utilised for minimally invasive hallux valgus (HV) deformity despite limited biomechanical data assessing the stability and strength of each construct. We aimed to compare the strength of various screw configurations for minimally invasive HV surgery using finite element analysis (FEA). METHODS A FEA model was developed from a CT of a female with moderate HV deformity. Five screw configurations utilizing one or two bicortical or intramedullary screws were tested. Stress analysis considered osteotomy displacement, maximum and minimum principal stresses, and von Mises stress for both implants and bone for each screw configuration. RESULTS Fixation with two screws (one bicortical and one intramedullary) demonstrated the lowest values for osteotomy displacement, minimum and maximum total stress, and equivalent von Mises stress on the bone and screws in both loading conditions. CONCLUSION The optimal configuration when performing minimally invasive surgery for moderate HV is one bicortical and one intramedullary screw. LEVEL OF EVIDENCE Level III.

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来源期刊

Foot and Ankle Surgery ORTHOPEDICS-

CiteScore

4.60

自引率

16.00%

发文量

202

期刊介绍： Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society. The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.