Biomechanical study on external fixation of tibial fractures based on 3D printing

Wang Jing; Wurikaixi Aiyiti; Aihemaitijiang Yusufu

doi:10.12086/oee.2021.200383

Article navigation > Opto-Electronic Engineering > 2021 Vol. 48 > No. 7 > 200383

Next Article Previous Article

Wang J, Aiyiti W, Yusufu A. Biomechanical study on external fixation of tibial fractures based on 3D printing[J]. Opto-Electron Eng, 2021, 48(7): 200383. doi: 10.12086/oee.2021.200383

Citation:

Wang J, Aiyiti W, Yusufu A. Biomechanical study on external fixation of tibial fractures based on 3D printing[J]. Opto-Electron Eng, 2021, 48(7): 200383. doi: 10.12086/oee.2021.200383

Biomechanical study on external fixation of tibial fractures based on 3D printing

1.
School of Mechanical Engineering, Xinjiang University, Urumqi, Xinjiang 830047, China
2.
Department of Microsurgical and Reconstruction, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830054, China

Fund Project: National Natural Science Foundation of the Xinjiang Uygur Autonomous Region (2019D01C040)

More Information

^*Corresponding author: Wurikaixi Aiyiti, E-mail: wurikaixi@sina.com

Received Date 19 October 2020

Revised Date 30 March 2021

Published Date 15 July 2021

Abstract

Abstract

The tibial shaft fracture model was customized by reverse engineering and 3D printing technology, and the biomechanics of the Orthofix Unilateral External Fixator for tibial shaft fracture was studied. Through the design of an orthogonal experiment scheme, the distribution of the Schanz's nails on the clamp, the distance from the lateral the Schanz's nails to the fracture end, and the distance from the tibia to the external fixture were measured by the XTDIC-CONST 3D Full-Field Strain Measurement and Analysis System. The experimental results show that when the number of the Schanz's nails decreased, the bending deformation of the Schanz's nails will increase from pressure load, which increases the possibility of plastic deformation and fatigue fracture of the external fixator. According to the mechanical analysis results of the nine schemes, the distance from the external fixture to the tibia has the most significant effect on the deformation of the Schanz nail. When installing six Schanz pins in the clip, the distance from the lateral Schanz's nail to the fracture end is 120 mm, and the distance from the external fixture to the tibia is 30 mm. The comprehensive performance of the scheme is the best.
- 3D printing /
- external fixation /
- orthogonal experiment /
- biomechanics

FullText(HTML)

References

[1]	卢秉恒, 李涤尘. 增材制造(3D打印)技术发展[J]. 机械制造与自动化, 2013, 42(4): 1-4. doi: 10.3969/j.issn.1671-5276.2013.04.001 CrossRef Google Scholar Lu B H, Li D C. Development of the additive manufacturing (3D printing)technology[J]. Mach Build Autom, 2013, 42(4): 1-4. doi: 10.3969/j.issn.1671-5276.2013.04.001 CrossRef Google Scholar
[2]	邓滨, 欧阳汉斌, 黄文华. 3D打印在医学领域的应用进展[J]. 中国医学物理学杂志, 2016, 33(4): 389-392. doi: 10.3969/j.issn.1005-202X.2016.04.014 CrossRef Google Scholar Deng B, Ouyang H B, Huang W H. Application progress of three-dimensional printing in medical field[J]. Chin J Med Phys, 2016, 33(4): 389-392. doi: 10.3969/j.issn.1005-202X.2016.04.014 CrossRef Google Scholar
[3]	阿依古丽·喀斯木. 3D打印技术在骨科手术辅助中的应用研究[D]. 乌鲁木齐: 新疆大学, 2017. Google Scholar Application of 3D printing technology in the orthopedic surgery assist[D]. Urumqi: Xinjiang University, 2017. Google Scholar
[4]	蒋明辉, 蔡立宏, 雷青, 等. 3D打印技术在骨科临床的应用研究及展望[J]. 中华损伤与修复杂志(电子版), 2016, 11(4): 288-290. doi: 10.3877/cma.j.issn.1673-9450.2016.04.011 CrossRef Google Scholar Jiang M H, Cai L H, Lei Q, et al. Application research and prospect of 3D printing technology in department of orthopedics[J]. Chin J Inj Repair Wound Heal (Electron Ed), 2016, 11(4): 288-290. doi: 10.3877/cma.j.issn.1673-9450.2016.04.011 CrossRef Google Scholar
[5]	王燎, 戴尅戎. 骨科个体化治疗与3D打印技术[J]. 医用生物力学, 2014, 29(3): 193-199. Google Scholar Wang L, Dai K R. Individualized treatment of orthopaedics and 3D printing technology[J]. J Med Biomech, 2014, 29(3): 193-199. Google Scholar
[6]	Lowenberg D W, Githens M, Boone C. Principles of tibial fracture management with circular external fixation[J]. Orthop Clin North Am, 2014, 45(2): 191-206. doi: 10.1016/j.ocl.2013.11.003 CrossRef Google Scholar
[7]	Emami A, Mjöberg B, Karlström G, et al. Treatment of closed tibial shaft fractures with unilateral external fixation[J]. Injury, 1995, 26(5): 299-303. doi: 10.1016/0020-1383(95)00037-A CrossRef Google Scholar
[8]	Stoffel K, Dieter U, Stachowiak G, et al. Biomechanical testing of the LCP--how can stability in locked internal fixators be controlled?[J]. Injury, 2003, 34(S2): B11-B19. doi: 10.1016/j.injury.2003.09.021 CrossRef Google Scholar
[9]	Kouassi K J E, Cartiaux O, Fonkoué L, et al. Biomechanical study of a low-cost external fixator for diaphyseal fractures of long bones[J]. J Orthop Surg Res, 2020, 15(1): 247. doi: 10.1186/s13018-020-01777-5 CrossRef Google Scholar
[10]	Shi D, Liu K Y, Zhang H M, et al. Investigating the biomechanical function of the plate-type external fixator in the treatment of tibial fractures: a biomechanical study[J]. BMC Musculoskelet Disord, 2020, 21(1): 128. doi: 10.1186/s12891-020-3144-5 CrossRef Google Scholar
[11]	Moazen M, Calder P, Koroma P, et al. An experimental evaluation of fracture movement in two alternative tibial fracture fixation models using a vibrating platform[J]. Proc Inst Mech Eng Part H, 2019, 233(5): 595-599. doi: 10.1177/0954411919837304 CrossRef Google Scholar
[12]	阿孜古丽·克热木, 乌日开西·艾依提, 滕勇. 接骨板固定股骨干骨折的有限元分析[J]. 机械设计与制造, 2020(9): 172-175. doi: 10.3969/j.issn.1001-3997.2020.09.041 CrossRef Google Scholar Keremu A, Aiyiti W, Teng Y. Finite element analysis of bone plate fixation for femoral shaft fracture[J]. Mach Des Manuf, 2020(9): 172-175. doi: 10.3969/j.issn.1001-3997.2020.09.041 CrossRef Google Scholar
[13]	张剑锋. 3D打印组配式节段型人工假体重建骨干缺损的实验研究[D]. 天津: 天津医科大学, 2019. Google Scholar Zhang J F. Experimental study on reconstruction of diaphyseal defect with 3D-printing modular intercalary endoprosthesis[D]. Tianjin: Tianjin Medical University, 2019. Google Scholar
[14]	Gao F Y, Wang Q, Liu C X, et al. Individualized 3D printed model-assisted posterior screw fixation for the treatment of craniovertebral junction abnormality: a retrospective study[J]. J Neurosurg: Spine, 2017, 27(1): 29-34. doi: 10.3171/2016.11.SPINE16713 CrossRef Google Scholar
[15]	Li L, Yang L F, Yu F, et al. 3D printing individualized heel cup for improving the self-reported pain of plantar fasciitis[J]. J Transl Med, 2018, 16(1): 167. doi: 10.1186/s12967-018-1547-y CrossRef Google Scholar
[16]	刘豫新. 锁定钢板工作长度对股骨干骨折力学的影响[D]. 天津: 天津医科大学, 2017. Google Scholar Liu Y X. The effect of working length of locking plate on the mechanics of femoral shaft fracture[D]. Tianjin: Tianjin Medical University, 2017. Google Scholar

Overview

Overview

Overview: The combination of 3D printing technology and medical treatment has excellent application prospects in auxiliary surgery, personalized medical devices, tissue engineering, medical education, and basic scientific research, especially in orthopedics, which has received more and more attention and application research. The external fixture is an effective treatment for the fracture. Different patients have different external fixation parameters due to different fracture locations. The implantation effect of external fixations is not ideal, which may bring the risk of the secondary operation. Therefore, a detailed and appropriate preoperative surgical plan is particularly important. With the wide application of 3D printing technology in orthopedics, preoperative biomechanical analysis of customized medicine has become a research hotspot.

Doctors usually choose the type of external fixation, the location of the installation, and the number of Schanz's nails according to their experience. When the fixation scheme is unreasonable, it will cause poor stability of external fixations and even lead to the fracture of Schanz's nail. In this paper, a biomechanical study was conducted on the parameters of external fixation for a patient with a tibial fracture, in order to finding a more reasonable fixation scheme, providing the basis of doctors to formulate the operation plan, reducing the operation time, and relieving the pain of patients.

The 1:1 tibial fracture model of patients with fracture was reconstructed by combining reverse engineering and 3D printing technology, which could be simulated more accurately according to the patient's situation. Through the design of the orthogonal experiment, the external fixation system was loaded with 0 N to 370 N for 5 times on a self-made compression testing machine. The deformation of the external fixture was measured by XTDIC-CONST 3D Full-Field Strain Measurement and Analysis System, including the distribution of Schanz's nail on the pin clamp, the distance from the outermost Schanz's nail to the fracture end, and the distance from the tibia to the external fixture.

According to the mechanical analysis results of the nine schemes, the 3D printing customized tibial fracture model is helpful to formulate a personalized treatment plan according to the patient's condition more accurately. The distance from the external fixture to the tibia has the most significant influence on the deformation of Schanz's nail. When installing six Schanz pins in the clip, the distance from the lateral Schanz's nail to the fracture end is 120 mm, and the distance from the external fixture to the tibia is 30 mm, and the stiffness of the external fixture is the largest.