肩部為人體最複雜的關節之一，肩部發生疼痛或受傷，都將嚴重影響人體上肢動作。肩部骨折為相當常見的肩部損傷，大都是因為高度碰撞運動傷害或車禍、摔倒造成，而鎖骨骨折占了肩部骨折總數的35%，且鎖骨擔任人體上肢與主幹連接的重要角色，因此鎖骨骨折應立即被治療。鎖骨中段三分之一骨折為最常見的鎖骨骨折，過去臨床上經常使用外部固定及植入物治療的方式進行臨床治療，但外部固定較容易產生不癒合或畸形癒合等相關併發症，因此臨床上建議使用植入物方式進行治療。植入物部份常使用骨板方式治療，過去已有少數文獻建立三維鎖骨模型並探討不同植入物位置相關問題，但皆使用單一鎖骨模型進行探討，且並未將所有植入物進行完整公平比較，因此本研究目的為建立一個完整人體上半部肩部骨骼肌肉模型，比較不同植入物治療方式的生物力學性能。
本研究使用SolidWorks建立一完整人體上半部肩部骨骼模型並使用ANSYS Workbench 14.5 加入肌肉韌帶進行有限元素分析，於肱骨施加200N向下力量模擬手提重物的狀況，再分別評估四種不同鎖骨骨折固定器，即：上方板固定、前方板固定、螺旋板固定、骨髓内釘固定。最後再以骨折固定穩定度、鎖骨應力、植入物強度結果，探討不同鎖骨骨折固定系統的優缺點。
本研究結果得知，螺旋板固定方式與其他骨折固定方式相比具有較佳的骨折固定穩定度，比對完整人體上半部肩部骨骼肌肉模型與單一鎖骨模型後發現加入肌肉韌帶後骨板類位移結果差異較不明顯，且骨板類治療方式與骨髓内釘方式相比有較好的骨折固定穩定度。上方板模型有較高的植入物應力產生，因此上方板較容易發生破壞、二次骨折等現象，本研究考慮到較完整人體模型，並可以真實模擬受力分佈狀況，可有效評估正常狀態及不同治療狀態的生力學性能。

Shoulder is one of the most complex joints in the body. It will severely affect human upper limb movements when shoulder injured. Shoulder fracture is quite common injury, and the height of the collision sports, car accident, and simple domestic falls were the possible reasons. Clavicle fractures accounted for 35% of the total number of fractures of the shoulder, and it is an important bone that connects the human upper limb and trunk. Therefore, clavicle fracture should be treated immediately. The middle third of the clavicle fracture is the most common collarbone fracture. In the past, external and internal fixations had been applied to treat the fractures. However, nonunion or malunion complications still occur after fracture treatments. In our knowledge, there are a few studies to analyze the biomechanical performances of clavicle fixation devices by using three-dimensional numerical model of human skeletal system. Most of the past studies used a single clavicle model to evaluate the biomechanics of the clavicle with or without fixation devices. Thus, the purposes of this study were to develop a complete human shoulder musculoskeletal model using finite element methods and to evaluate the biomechanical performances of different treatment methods.
The present study developed a complete human upper body model with muscles and ligaments using SolidWorks and ANSYS Workbench 14.5. Four types of fixation techniques were analyzed and discussed including the superior plate fixation, the anterior plate fixation, the spiral plate fixation, the intramedullary fixation. All the treated models were compared to the intact model. In postprocessing, the fixation stability, the bone stress, and the implant stress were calculated to investigate the strength and limitation of each fixation technique.
The results of this study showed that the spiral plate fixation has better structural stability compared with other fracture fixations. The plate fixation techniques have better fixation stability than the intramedullary nail. The superior plate fixation had higher implant stress compared with other fixations, and it would lead to a high risk of implant failure. The results of this study could fairly compare the biomechanics of different clavicle devices on the same basis, and provide surgical suggestions for clinicians.

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