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研究生:林緯則
研究生(外文):Wei-Tse Lin
論文名稱:人類下顎骨角斷裂固定手術之 有限元素分析
論文名稱(外文):Evaluation of Human Mandible Angle Fracture Fixation by Finite Element Analysis
指導教授:劉建緯黎文龍黎文龍引用關係
指導教授(外文):Chien-Wei LiuWenLung Li
口試委員:蔡定江
口試日期:2016-07-15
學位類別:碩士
校院名稱:國立臺北科技大學
系所名稱:製造科技研究所
學門:工程學門
學類:機械工程學類
論文種類:學術論文
論文出版年:2016
畢業學年度:104
語文別:中文
中文關鍵詞:有限元素分析骨板下顎骨斷裂
外文關鍵詞:finite element analysismini platehuman mandible fracture
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人類下顎骨於顏面中為僅次於鼻骨最易破壞的區域,而其中下顎骨角又是斷裂最頻繁的部位之一;顎間固定法(internal rigid fixation)是一通常的治療方式,以金屬骨板(mini plate)與螺絲貼合並鎖入斷裂區域以施與固定作用,但經文獻指出,接受手術後的病患有發生骨板失效的現象,甚至是生理上之併發症,因此,本研究使用有限元素分析法,模擬下顎骨模型接受不同的骨板與固定方式,探討在不同受力條件下,骨板的力學反應與對於斷裂處的穩固性。研究過程中,下顎骨有限元素模型取自臨床病患之CT圖檔轉換而成,貼合骨板則選用臨床常用廠牌Depuy Synthes的二種骨板,以逆向工程(RE)之手法回溯建立三維模型,將上述兩者建構於有限元素模型中,並設定兩種受力條件探討在不同受力狀況下之影響。為了探討骨板與鎖入之螺絲對固定手術之影響,本研究設計三個實驗因子及其水準,分別為骨板貼合高度(6 mm、8 mm、10 mm)、螺絲鎖固位置(4s、2a、2b)與骨板數量(1、2),以上述之因子建構模型於有限元素環境中進行模擬分析,分析後所得之觀測值再利用變異數分析,探討因子對於固定手術的影響程度。骨板系統的穩固性可從下顎骨斷裂處所產生之位移變化或間隙來做為評斷標準,故各個模型受力後之斷裂處位移將會被量測。
根據ANOVA分析結果,螺絲鎖固位置與骨板數量對於兩個骨板的影響是顯著的,但從骨板最大應力表現可觀察出,特定高度對於應力反應仍有影響;總結研究中的分析結果,本研究對於使用骨板之評估如下:004骨板以單片貼合於6 mm高度並鎖上四顆螺絲有最佳的固定效果,而701骨板則需於上下緣都各貼合一片骨板,且上緣需貼合於10 mm高度,如此能得最佳之固定效果。
Human mandible angle is one of the most fractured site at all time, it casually caused by traffic accident, assault or professional harm. A reduction called internal rigid fixation is commonly used on the therapy, which fixes the fracture sites by mini plates and screws. However, according to the clinical report, multiple cases of complication and plate or screws loosen had occurred after surgery. In this research, finite element analysis is conducted to evaluate an adequate fixation for mandible angle fracture. An individual mandible model was converted from CT graphics, the mini plates were selected form Depuy Snythes with series number 447.004(MandiblePlate2.0) and 04.503.701(MatrixMandible), those are constructed into 3D model and applied in commercial finite element software. Two loading cases are set to simulate the actual jaw movement, max forces of mandible muscles group and postoperative incisor biting force. In order to have further discussion of the affection between mini plate and the fixing ability, three experiment factors are designed with multiple levels, they are mini plate fitting position (6 mm, 8 mm, 10 mm) as factor A, the screws pin in position (4s, 2a, 2b) as factor B and number of mini plate(1, 2) as factor C, each factor is applied in FEA model, and the result observations will also analyzed with ANOVA method. Based on a clinical experiment research, the fracture gap should be less then 0.15 mm for properly healing, thus the displacements of the model fracture site would be measured as a measurement to evaluate the stability of a fixation.
The result of ANOVA method, factor B and C has significant different in max stress of mini plate and displacements of fracture site. Although mostly result of factor A are not significant, it’s still apparently to see there is a pattern in max stress value of mini plate. The best fixation are suggested at below: a single 004 mini plate should be placed at 6 mm height and full screwed, double 701 mini plate should be used in one fractured site, the upper plate should be placed at 10 mm height.
摘 要 i
ABSTRACT iii
誌謝 v
表目錄 ix
圖目錄 xi
緒論 1
1.1 前言 1
1.2 下顎骨與顳顎關節 2
1.3 下顎骨肌肉 5
1.3.1 閉合肌肉 6
1.3.2 開合肌肉 8
1.4 下顎固定手術與骨板 10
1.4.1 下顎骨角斷裂 10
1.4.2 固定手術 11
1.4.3 骨板 12
1.5 文獻回顧 13
1.6 研究動機與目的 18
第二章 研究方法與流程 19
2.1 研究流程 19
2.2 模型建構 21
2.2.1 下顎骨三維模型建立 21
2.2.2 骨板三維模型建立 24
2.2.3 骨板與螺絲CAD模型 31
2.3 有限元素模型 32
2.3.1 模型座標訂定 33
2.3.2 材料性質 35
2.3.3 下顎骨肌肉力設定 36
2.3.4 下顎骨邊界條件設定 39
2.3.5 接觸設定 43
2.3.6 網格設定 43
2.3.7 破壞與檢定準則 45
2.3.8 模型簡化與驗證 46
2.4 實驗設計 49
2.4.1 因子設計 49
2.4.2 骨板種類與貼合位置 49
2.4.3 螺絲鎖固位置 53
2.4.4 骨板數量 54
2.4.5 變異數分析 56
第三章 研究結果 60
3.1 骨板位置對應力表現與穩固性之結果 60
3.1.1 型號447.004 61
3.1.2 型號04.503.701 68
3.2 二顆螺絲位置變化對下顎骨力學表現結果 73
3.2.1 型號447.004 74
3.2.2 型號04.503.701 84
3.3 雙邊骨板對應力表現與穩固性之結果 96
3.3.1 型號447.004 96
3.3.2 型號04.503.701 106
第四章 結果討論 114
4.1 骨板貼合位置之影響比較 114
4.2 螺絲鎖固位置之影響比較 118
4.3 骨板數量之影響比較 123
4.4 骨板間之結果與比較 128
4.5 骨板701貼放位置比較 131
4.6 骨質變化之影響 134
第五章 結論與建議 135
5.1 未來與展望 136
參考文獻 138
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