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研究生： 趙建堯
Chao, Chien-Yao
論文名稱： 橈骨骨板之生物力學探討
Biomechanics of Radius bone plate
指導教授： 張志涵
Chang, Chih-Han
學位類別： 碩士
Master
系所名稱： 工學院 - 生物醫學工程學系
Department of BioMedical Engineering
論文出版年： 2012
畢業學年度： 100
語文別： 英文
論文頁數： 47
中文關鍵詞： 遠端橈骨掌側骨板 、遠端橈骨背側骨板 、有限元素分析
外文關鍵詞： distal radius fracture, distal radius volar plate, distal radius dorsal plate, finite element method
相關次數： 點閱：102  下載：4 
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    • 橈骨為人體中最常發生骨折的部位之一，所以橈骨骨折的治療為一相當重要的課題。現今臨床所使用之遠端橈骨骨板可分為掌側(volar)及背側(dorsal)骨板，根據橈骨創傷的形式加以選擇較適合之骨板，但是橈骨背側相較掌側有許多肌腱及血管通過，背側骨板常與肌腱相互摩擦造成肌腱發炎或斷裂，所以臨床上若是患部復位情形良好醫師常會選用掌側骨板來加以治療。本研究目的為評估使用橈骨掌側及背側骨板對Type C 遠端橈骨骨折加以固定之生物力學特性。
    本研究之三維有限元素模型包括橈骨、三種橈骨背側骨板(Synthes 2.4mm dorsal plate, Synthes 2.4 mm styloid plate and聯合骨科L-type Distal Radius plate)、橈骨掌側骨板 (Synthes 2.4 mm LCP Volar plate)與骨釘，依臨床手術規劃術後模型，並探討橈骨掌側及背側骨板對於遠端橈骨骨折治療之生物力學影響。並探討不同之外力形式對於骨釘骨板之生物力學特性的影響。
    市售產品分析的部份其結果發現若是針對Type A之骨折形式加以固定，則針對患部之穩定性來看，聯合骨科所生產之橈骨背側骨板相較於Synthes公司所生產之骨板能提供較佳之術後穩定度。另外若是針對骨折面之相對穩定性加以探討，則根據模擬的結果可發現掌側骨板在受到軸向力以及扭矩時相對於背側骨板能提供患部較大之穩定性。

    Radius is one of the most fractured sites of the whole body; therefore, the treatment of radius fracture is a very important issue. Two types of bone plate, the volar plate and the dorsal plate, are available for the distal radius bone fracture. In general, surgeons choose the plate based on the fracture mode. But some surgeons prefer the volar plate than the dorsal plate due to the fact that many tendons and blood vessels near the radius dorsal side which makes the surgery difficult. The aim of this study was to investigate the biomechanical responses of treating type-C distal radius fracture, a fracture mode in general fit dorsal plate, using valor plate and dorsal plate.
    Based on surgical guidance of distal radius reconstruction, three-dimensional finite element models consisted of distal radius, with type-C fracture, distal radius bone plate, double-platting dorsal plate system or single volar plate, and bone screws was established from intact computed tomography images. Various loading modes were applied on the model to justify the biomechanical response of restoration with various bone plate.
    The outcomes showed that even in type-C fracture, a fracture mode considered to be fitted for dorsal plate fixation, a volar plate is performed, in terms of stability, better than the dorsal plate, double-platting system.

    Contents Abstract I 中文摘要 II 致謝 III Table contents VIII Figure contents IX Chapter 1 Introduction 1 1.1 The anatomy of the radius 2 1.1.1 The anatomy of radius 2 1.2 Radius fracture 4 1.2.1 The pathology of radius fracture 4 1.2.2 The types of radius fracture 4 1.2.3 The epidemiology of distal radius fracture 5 1.3 The bone plate 7 1.3.1 Types of the bone plate 7 1.3.2 Types of the distal radius bone plate 8 1.3.3 The material of internal fixation bone plate 9 1.4 Literature Review 11 1.5 Motivation and Purpose 14 Chapter2 Materials and methods 16 2.1 Flow chart 16 2.2 Finite element model 17 2.2.1 Construction the 3D radius model 17 2.2.2 Construction the 3D Implant Model and Post-Operative Model 18 2.2.3 Material Properties, Loading Conditions, Boundary Conditions and Contact interface 20 2.3 The simulation parameter 21 Chapter3 Results and Discussion 25 3.1 Analysis of commercial products 26 3.1.1 The deformation distribution of distal radius under moment and axial loading 26 3.1.2 The stability of fracture surface under axial loading and moment when fixing with the L-type distal radius bone plate 28 3.1.3 The influence of distal radius fracture surface stability under different pretention magnitude 31 3.2 The biomechanics of distal radius volar plate fixed the distal radius bone fracture 32 3.2.1 The deformation distribution of distal radius under moment and axial loading 32 3.2.2 The stability of fracture surface under axial loading and moment when fixing with the distal radius volar plate 33 3.3 The biomechanics of distal radius dorsal plate fixed the distal radius bone fracture 35 3.3.1 The deformation distribution of distal radius under moment and axial loading 35 3.3.2 The stability of fracture surface under axial loading and moment when fixing with the distal radius dorsal plate 37 3.4 Convergence test and model validation 38 3.5 Summary 41 Chapter4 Conclusions 44 Reference 45

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