三维有限元方法构建足部健康骨骼与常见疾病模型及生物力学分析

文题释义： 有限元分析：利用数学近似的方法对真实物理系统进行模拟，还利用简单而又相互作用的元素，即单元，用有限数量的未知量去逼近无限未知量的真实系统。它将求解域看成是由许多称为有限元的小的互连子域组成，对每一单元假定一个合适的近似解，然后推导求解这个域总的满足条件，从而得到问题的解。由于大多数实际问题难以得到准确解，而有限元不仅计算精度高，而且能适应各种复杂形状，因而成为行之有效的工程分析手段。 DICOM：即医学数字成像和通信，是医学图像和相关信息的国际标准(ISO 12052)。它定义了能满足临床需要的可用于数据交换的医学图像格式。DICOM被广泛应用于放射医疗、心血管成像以及放射诊疗诊断设备(X射线、CT、核磁共振、超声等)，并且在其他医学领域得到越来越深入广泛的应用。在数以万计的医学成像设备中，DICOM是部署最为广泛的医疗信息标准之一。当前大约有百亿级符合DICOM标准的医学图像用于临床使用。 背景：在创伤骨科方面，三维有限元分析不仅仅作为骨折内固定治疗过程中生物力学评估和内固定器材设计、优化的常规手段，近年来也为创伤骨科基础与临床研究开拓新的方向。 目的：对足部正常骨骼、扁平足、马蹄足、足部骨折病例进行三维建模及生物力学分析。 方法：选取健康受试者以及扁平足、马蹄足、足部骨折患者进行足部CT检查，根据检查数据利用计算机三维成像技术进行三维有限元建模及生物力学分析，根据分析结果得到足部健康骨骼、扁平足、马蹄足及足部骨折应力分布图以及应力值等数据，并对数据结果进行分析。该研究获得福建医科大学附属闽东医院伦理批准。 结果与结论：建立足部正常骨骼、扁平足、马蹄足、足部骨折模型并进行生物力学分析，扁平足患者跖骨、跗骨应力值较正常明显增加，马蹄内翻足的应力主要集中于踝关节周围，尤其是在距骨关节面。单纯跖骨骨折对于足跗骨区域应力变化影响较小，Lisfranc损伤患者的足跗骨区应力较正常足部增加较明显。该研究以足部三维有限元建模和生物力学分析将计算机技术与临床实际相结合，为人体足部生物力学研究提供参考，通过应力分析将多种足部情况的力学信息数值化，为足部的临床治疗提供了重要的力学依据。 ORCID: 0000-0002-7688-6990(何晓宇) 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Establishment of normal foot and common foot disease models using three-dimensional finite element method and biomechanical analysis

BACKGROUND: In the field of trauma orthopedics, three-dimensional finite element analysis is only a routine means of biomechanical evaluation and internal fixator design and optimization in the treatment of internal fixation of fractures, but also provides new directions for the basic and clinical researches of trauma orthopedics. OBJECTIVE: To establish a three-dimensional finite element model of normal foot, flatfoot, equinus, and foot fracture and to undergo biomechanical analysis. METHODS: One healthy volunteer and patients with flatfoot, equinus, and foot fracture were selected. Their feet were scanned by CT. Three-dimensional finite element modeling and biomechanical analysis were performed by using computer three-dimensional imaging technology according to the CT data. The stress distribution and stress values of each model were then obtained for comparative analysis. The study was approved by the Ethics Committee of Mindong Hospital Affiliated to Fujian Medical University. RESULTS AND CONCLUSION: The three-dimensional finite element models of normal foot, flatfoot, equinus, and foot fracture were established and biomechanical analysis was performed. In the patients with flatfoot, the stress values of the metatarsus and tarsus were significantly increased compared with the normal values. The stress of the equinus was mainly concentrated around the ankle joint, especially on the talus surface. The simple metatarsus fracture had little effect on the stress changes in the tarsus area. The stress in the tarsus area of the Lisfranc injured patients was increased more obviously than in the normal feet. In this study, the three-dimensional finite element modeling and biomechanical analysis of the foot combines computer technology with clinical practice, which provides reference for biomechanical research of human foot. The numericalization of the mechanical data of different foot conditions by mechanical analysis provides important mechanical basis for the clinical treatment of the foot.