解放军医学院学报2025，Vol.46Issue(9)：875-882,8.DOI:10.12435/j.issn.2095-5227.25011901
有限元分析不同固定方式在肱骨远端骨折骨愈合中的生物力学差异
Finite element analysis of biomechanical differences among various fixation methods in bone healing of distal humeral fractures
摘要
Abstract
Background The optimal fixation method for distal humeral fractures(DHF)remains controversial.Current biomechanical studies mainly focus on evaluating the stiffness and stability of different fixation techniques,while dynamic analysis over the entire healing period is lacking.Objective To comprehensively evaluate the biomechanical conditions of different fixation methods(parallel plating vs orthogonal plating)during the healing process of distal humeral fractures,enhance the understanding of plate configuration selection,and introduce necessary restrictions during the fracture healing and rehabilitation process to achieve more ideal treatment of DHF.Methods A finite element(FE)model of a distal humeral fracture was constructed based on elbow CT data from a healthy 30-year-old male.Models of parallel and orthogonal plating were developed,along with a transient callus model based on computational mechanics.Finite element analysis using ANSYS software was conducted at different healing stages(immediately postoperative,and at 1,3,and 6 months postoperatively)to evaluate relative displacement at the fracture site,peak callus stress,and maximum stress distribution within the humerus and fixation constructs.Simulations incorporated three types of loading conditions to mimic daily elbow activities:axial,bending,and varus loading.Results In the early postoperative period(0-3 months),the parallel plating group showed significantly greater fracture site displacement under axial and bending loads compared to the orthogonal plating group,whereas it exhibited less displacement under varus loading.At 0 and 1 month postoperatively,the peak callus stress in the parallel plating group was lower than that in the orthogonal plating group.Additionally,the fixation construct in the orthogonal group experienced higher stress levels early after surgery,which gradually decreased over time.The orthogonal plating configuration exhibited a more uniform stress distribution,with displacement and stress levels maintained within a favorable range.These findings suggested that parallel plating offered superior initial stiffness and stability,while orthogonal plating provided more reliable long-term performance during later healing stages.Conclusion Finite element analysis indicates that parallel plating offers higher stiffness and stability in the early postoperative period but may lead to stress concentration within the fixation construct,potentially increasing the risk of complications.In contrast,orthogonal plating demonstrates more uniform stress distribution and greater reliability during later stages of fracture healing.Clinical decision-making regarding fixation strategies should consider the patient's individual needs and the entire healing timeline to optimize treatment outcomes.关键词
肱骨远端/骨折愈合/有限元分析法/生物力学Key words
distal humerus/fracture healing/finite element analysis/biomechanics分类
医药卫生引用本文复制引用
贾争锋,高伟录,李建涛..有限元分析不同固定方式在肱骨远端骨折骨愈合中的生物力学差异[J].解放军医学院学报,2025,46(9):875-882,8.基金项目
国家自然科学基金项目(82302788) （82302788）
