臺灣博碩士論文加值系統

Abstract

Distal radius fracture is one of the common fractures. Recently some specially designed external fixators have been widely used for the treatment of such fracture and surgically related complications. There are two kinds of wrist external fixator: non-briding fixator and briding fixator. Non-briding fixator can fix on the radius directly; there is no mechanical restriction of wrist movement with a non-bridging fixator after treatment. It has widely ROM and better reduction of distal radius fractures. But it can’t be used in the fracture with articular surfaces or comminuted fracture. Briding fixator has first insert pins to the radius and second metacarpal individually, when set fixator to the pin. Because those fixators have set across the axis of wrist, it’s usually designed as a device composed of hinge or ball joint, the main purpose of this design is in line with the axis of wrist, it can supply to the range of motion of the wrist and avoid the squeal of the wrist joint stiffness. Besides, the continuously passive motion can be done by detraction device. However, there have been some commercial wrist fixators which are often bulky and design complicated, inducing inconvenience during the rehabilitation.
In this study, we firstly improved now commercial fixators and designed a new wrist fixator. Assuming a new wrist fixator and the associated radius and second metacarpal bone as a close chain system, the principle of homogeneous transformation matrix of robotics is applied in the kinematic analysis of such a chain system. Consequently, the pin placements are parameterized and their kinematic influences on the adjustability, which are in line with wrist axis of the new fixators, are analyzed. The numerical results of the current study are validated by the trigonometric model and computerized simulation. In addition, the contribution for each design parameter of external fixator was thus investigated by the Taguchi method
In conclusion, the current study has designed a newly wrist external fixator. Furthermore, the new fixator is validated by the homogeneous transformation matrix and Taguchi method. The results of this study can help orthopedic surgeons take insight into the operation restraints of such a new technique. In the future, the same concept can be clinically applied to the treatment of the hinged knee and ankle joints.

目 錄

頁次
中文摘要…………………………………………………………... I

英文摘要…………………………………………………………... II

誌謝………………………………………………………………... III

目錄………………………………………………………………... IV

符號索引………………………………………….……………….. VIII

圖表索引…………………………………………….…………….. XII
第一章 緒論………………………………..……………………... 1
1.1研究動機與目的..…..……………………….…………….. 1
1.2手部與腕關節之解剖學...………………………………… 2
1.3腕關節旋轉軸的運動學探討……………………………… 4
1.4橈骨骨折與臨床治療方式………………………………… 5
1.5腕關節骨外固定器之介紹…….……………...…………… 7
1.5.1跨腕關節式骨外固定器介紹………………………… 8
1.5.2非跨腕關節式骨外固定器介紹……………………… 10
1.6本文架構…………………………………………………… 11
第二章 研究方法…………………………………………………. 19
2.1腕關節骨外固定器之設計………………………………… 19
2.1.1新型非跨腕關節式骨外固定器之設計……………… 19
2.1.2新型跨腕關節式骨外固定器之設計………………… 21
2.2齊次轉換矩陣的數學原理與臨床應用…………………… 22
2.2.1空間座標與轉換……………………………………… 23
2.2.2順向運動學…………………………………………… 25
2.2.3逆向運動學…………………………………………… 25
2.2.4球關節之描述………………………………………… 26
2.3橈骨、掌骨與骨外固定器連桿系統的建立……………… 27
2.3.1新型骨外固定器的自由度分析……………………… 27
2.3.2座標系統與參數之建立……………………………… 29
2.4腕關節與骨外固定器矩陣系統之建立…………………… 31
2.4.1新型骨外固定器之齊次轉換矩陣…………………… 31
2.5腕關節與骨外固定器系統的數值原理分析……………… 34
2.5.1求解運動鏈方程式…………………………………… 37
2.5.2兩側之球關節轉動角度之計算……………………… 38
2.5.3中間U型關節轉動角度之計算……………………… 38
2.6三角幾何模型……………………………………………… 39
2.6.1模型定義………………………………………………. 39
2.6.2骨釘偏移之計算………………………………………. 40
2.6.3骨釘傾斜之計算………………………………………. 41
2.7電腦模擬驗證……………………………………………… 43
2.8田口方法…………………………………………………… 43
2.8.1直交表…………………………………………………. 45
2.8.2資料分析………………………………………………. 45
2.8.3變異數分析……………………………………………. 46
第三章 分析結果………….……………………………………… 62
3.1骨外固定器調整範圍之分析結果………………………… 62
3.1.1骨釘偏移影響之數值分析……………………………. 62
3.1.2骨釘偏移影響之三角幾何驗證………………………. 63
3.1.3骨釘傾斜影響之數值分析……………………………. 63
3.1.4骨釘傾斜影響之三角幾何驗證………………………. 64
3.2骨外固定器之電腦模擬………………………………….. 65
3.3田口法參數化分析結果………………………………….. 66
3.4田口法結果確認………………………………………….. 67
第四章 討論………………………………………………………. 85
4.1新型腕關節骨外固定器設計討論………………………… 85
4.1.1非跨腕關節式骨外固定器設計討論…………………. 87
4.1.2跨腕關節式骨外固定器設計討論……………………. 88
4.2齊次轉換矩陣數值分析結果討論………………………… 90
4.3田口法分析結果討論……………………………………… 92
4.4綜合討論…………………………………………………… 93
第五章 結論與未來展望…..……………………………………... 99
5.1結論…………………………………..……………………. 99
5.2未來展望……………………………..………………….… 100
參考文獻…………………….…………………………………….. 101
附錄………………………………………………………………... 105
作者簡介………………………………………………………...… 110

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