内收型股骨颈骨折多根空心螺钉固定的三维有限元分析  

Three-dimensional finite element analysis of two and three cannulated hip screws fixation for adductive femoral neck fractures

作　　者：杨成伟[1] 李全[1] 孙伟[1] 张治宇[1] 蔡郑东[1] 

机构地区：[1]第二军医大学长海医院骨科,上海200433

出　　处：《中国矫形外科杂志》2009年第14期1077-1080,共4页Orthopedic Journal of China

摘　　要：[目的]通过三维有限元法对内收型股骨颈骨折的不同多根空心螺钉内固定方式进行对比评价,比较3根螺钉固定和2根螺钉固定的优缺点,为临床应用提供理论依据。[方法]以内收型股骨颈骨折为研究对象建立模型,根据人正常行走时的3种步态情况,给予股骨头不同的关节压力和肌肉拉力,分别进行有限元计算。[结果]脚跟着地和中立位时,2根螺钉和3根螺钉固定后各项指标无明显差别;而脚尖离地时,2根螺钉固定较3根螺钉固定模型的抗张力和抗扭转指标差。按倒三角方式三钉固定模型的各指标在3种受力情况下均比较好。[结论]2根螺钉固定的效果与受力方向有关,3根螺钉固定的方式更可靠更安全,临床上建议尽量采取三钉固定的方式。[ Objective] To explore the biomechanical stability of fixation with two and three cannulated compression screws in treatment of the adductive femoral neck fractures by the three-dimensional finite element analysis （ FEA ）. [ Method ] Two FEA models of two screws and three screws for adductive femoral neck facture fixations were set up to investigate the simulated loading of three different conditions. [ Result ] At the condition of the heel touching the ground and the middle position, there was no difference in the biomechanical stabilities of the two models. However, at the condition of the tiptoe departing from the groud, the model of three screws fixation was better in torsion resistance and stretching resistance. [ Conclusion] The biomechanical stability of fixation with two screws is determined by the direction of loading. Three cannulated compression screws fixation provides better biomechanical stability.

关 键 词：股骨颈骨折 内固定 生物力学 有限元分析 

分 类 号：R687.3[医药卫生—骨科学]