摘要
因外力撞擊或高處墜落所造成的骨頭斷裂，在治療上最難處理的案例就屬，伴隨軟組織嚴重受創之開放性骨折。目前採用外固定器已成臨床治療準則，但現階段普遍使用的傳統外固定器不僅笨重、體積龐大且容易刺傷對側正常肢體，嚴重影響病患生活起居。近幾年研究顯示鎖定式骨板作為外固定器之可行性，雖然有效解決外固定器缺點，在臨床上也獲得良好治療效果，但這並非原先鎖定式骨板之適應症。 本研究所設計之新型外固定器，與臨床醫師討論初步概念後進行原型試製，觀察外型結構與固定機制。並使用有限元素法對於新型、傳統與骨板外固定器進行比較，評估設計結構是否具備足夠的強度。接著將試製新型外固定器原型，植入人工脛骨進行力學測試，觀察是否保有足夠的穩定性。最後針對新型外固定器之運用與變換結構，進行不同參數的模擬分析，了解是否仍維持足夠的結構強度。 由電腦分析結果顯示，新型外固定器在原先設定之設計結構，與變換結構的改變下，相較於傳統與骨板外固定器，仍具備足夠的強度。在力學測試中模擬人體之循環負載，結果仍保有足夠的穩定性。本研究所開發之新型外固定器，具備結構微型化、良好穩定性且固定位置廣等特點，不僅臨床醫師操作便利，也降低於病人日常生活之影響。
並列摘要
Fracture was often observed in accidents, especially caused by high energy impact. Open tibial fracture with severe soft tissue damage was the most complicated case in lower limb fracture and difficult to be treated. However, the conventional external fixation still has many disadvantages, such as inconvenient daily life resulted from the excessive volume and weight, irrigation of the opposite limb, bone malalignment owing to weak structure, joint stiffness due to the fixation was crossing the joint and muscle hypotrophy caused by immobilization, etc. Recently, locking plate was adopted as the external fixators and achieved acceptable results. Although it has lower profile and lesser weight than conventional external fixator, the application of this approach was still limited. This study is to develop a novel bone external fixator to include advantages of both traditional external fixator and locking plate. After manufacturing the prototype of the novel external fixator, therefore, investigation of the structural stiffness of different external fixators (traditional external fixator, external locking plate and novel bone external fixator) was applied by finite element analysis. Furthermore, mechanical test was executed to evaluate the stability of novel bone external fixator. Finally, finite element analysis was executed to evaluate the structural stiffness of different configuration of novel bone external fixator. The results of finite element analysis showed that novel external fixator (design, application and conversion structure) had better structural stiffness than the conventional external fixator and external locking plate. Furthermore, the results of mechanical fatigue test showed that novel external fixator has sufficient structural stability. Hence, this novel external fixator has many advantages, such as light-weighted, small volume and low profile, for further application.