- 學位論文
使用不同固定方法於下顎骨聯合處斷裂之生物力學分析
Biomechanical Analysis of Mandibular Symphyseal Fracture with Different Fixation Configurations
摘要
根據統計得知，下顎骨骨折是最常見的面部受傷，導致下顎骨聯合處斷裂以交通事故與鬥毆為主要原因，佔所有面部骨折20％。然而Symphseal Fracture(聯合處骨折)的固定方式，目前多為依靠臨床醫師之經驗來決定其定位，但並沒有一個確切的準則。 本研究之目的主要是探討在正常咬合力、五種肌肉拉力下，與臨床醫師討論提出三種相同孔洞數(四孔)骨板之固定方法(傳統微型固定法、短骨板固定法、不同維度短骨板固定法)於治療下顎骨聯合處斷裂，以電腦輔助設計工程、分析軟體以及體外實驗來進行驗證，並觀察其應力分布以及採用三維數位影像相關法(Three dimensional Digital Image Correlation, 3D-DIC)觀察其位移量，期望藉由模擬分析與體外實驗之結果以提供臨床醫師在手術前得到最適合的固定方式，進而提高整體結構上的穩定性以及手術的效率和可靠度。 研究結果顯示，改變固定方式對下顎整體結構之穩定性是有影響的。在三種固定方式中，可推論以二維度固定方式來進行下顎骨聯合處斷裂手術可達到較佳的穩定性。
並列摘要
Mandibular fractures are the most common facial trauma with 23–97% of all facial fractures. The major fracture sites are located in the condylar neck, the symphysis and the body or angle of the mandible. Fractures through the mandible at the level of the symphysis is relatively common and account for approximately 20% of mandibular fractures. However, the fixations of the symphyseal fracture are mostly relied on the experience of the clinician to determine its position, but doesn’t have a precise guidelines. The purpose of this study was to investigate various fixations of mandibular symphyseal fracture during masticatory load by three-dimensional finite element (FE) analysis and in-vitro experiment. The displacement of mandible was recorded by the three dimension digital image correlation (DIC) to simultaneously capture the same regions of interest on the object surface from two different positions and orientations. The stress distribution and the displacement of the mandible were analyzed for further comparison. The results of this study would provide appropriate stability and reliability of bone plate fixation to the mandibular symphyseal fractures.