摘要
肩部關節退化是一種常見的關節退化過程，可能會引起肩部疼痛
，也可能會進而引起肩部發炎等症狀。近幾年，遠端鎖骨切除在骨外科手術上藉由切除靠近肩峰端之遠端鎖骨進行治療，切除病患的疼痛處並可使被切除的鎖骨段再生富有彈性的軟組織、或填充人工組織方式來達到治療肩部疼痛的效果。本研究以有限元素分析協助醫師於骨外科手術中找出遠端鎖骨的最佳切除深度與位置。本研究以ANSYS軟體進行有限單元模型分析，分別以二維(2D)及三維(3D)之肩部模型進行分析與討論。骨外科之肩部關節手術中有許多方法可以進行，但手術後病人的復原狀況不同，有些病人手術後仍會有疼痛感甚至更為嚴重。因此，本研究希望以不同骨外科手術之方式分別進行模擬，探討不同切除深度、切除範圍和切除部位的影響，並由模擬結果解釋病人術後的疼痛原因。本研究中，探討二維(2D)與三維(3D)人體肩部結構中差異性也是重點之一，若二維分析的結果可以合理接受，則可有效簡化複雜的肩部三維結構分析。根據本研究的結果，使用直接法的遠端鎖骨切除手術所造成的整體結構應力值會比較小且鎖骨最佳切除深度為0.6 公分。

Acromioclavicular degenerative change is a normal aging process and may cause shoulder pain. Distal clavicle resection is one of the therapies in arthroscopic surgery for curing shoulder pain by removing the end of the clavicle close to the acromion. The purpose of this research is to find the appropriate resection position and resection depth in arthroscopic surgery by finite element code ANSYS, with a two dimension (2D) and a three dimension (3D) finite element models. There were many literatures and methods in arthroscopic surgery, but no one could explain the resection depth and position properly. Owing to different resection methods, some patients still felt pain after surgery. By changing resection depth, resection range, and resection position, the simulation results were able to suggest the suitable surgery method and to explain the reason. This study used 2D and 3D finite element models to analyze the distal clavicle resection surgery, the 2D model was simplified from the 3D model, and the difference in these two models were compared and discussed. Reasonable results obtained from the 2D model in the analysis of shoulder could increase the computational efficiency, if 3D analysis is not mandatory.

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