带血管蒂大转子骨瓣转移治疗股骨头缺血坏死的生物力学研究  

Biomechanical study of vascularised greater trochanter bone flap in treatment of necrosis of femoral head:finite element analysis

作　　者：赵德伟[1] 田丰德[1] 郭林[1] 杨磊[1] 王本杰[1] 陈秉智[1] 

机构地区：[1]大连大学附属中山医院骨科,大连116001

出　　处：《中国临床解剖学杂志》2009年第5期580-583,共4页Chinese Journal of Clinical Anatomy

基　　金：国家自然科学基金资助项目(30670542)

摘　　要：目的:应用三维有限元方法检测带血管蒂大转子骨瓣移植修复前后股骨近端的力学特性变化,验证该术式力学安全性及有效性,指导临床工作。方法:选取单侧ARCOⅢ期股骨头坏死并行带血管蒂大转子骨瓣移植患者,术前及术后6个月行股骨近段的螺旋CT扫描,应用专业医学建模软件MIMICS及HYPERMESH建立正常、坏死和修复三组三维有限元模型。应用有限元分析软件ANSYS模拟人体站立及运动等不同情况,设置边界条件和加载条件,执行计算。结果:三组模型大转子及股骨颈前方均表现为低应力低应变区;坏死模型可见部分压力骨小梁被破坏呈囊性变,其与正常骨小梁交接处存在应力集中;修复模型股骨近端的力学特性与正常模型相近,结果明显优于坏死模型。结论:带血管蒂大转子骨瓣转移方法治疗股骨头缺血坏死是安全、有效的。Objective： To explore biomechanical effects of vasculafized greater trochanter bone flap on treating avascular necrosis of femoral head （ANFH）, and to predict its safe and efficacy during clinic application. Methods： A patient suffered from ANFH with his right femoral （ARCO Ⅲ） was selected and treated with vascularized greater trochanter bone flap. Helix CT Scanning was performed on the upper femur preoperatively and 6 months postoperatively, dealing CT image （DICOM） with MIMICS and HYPERMESH software, coordinate values of the femur were input into the computer to build up three dimensional finite element models by ANYSY-8.0 software, and then, simulating different circumstance, different amount and direction of loading on the femoral head were put respectively for stress distribution analysis. Results： The outcome of three models matched with the actuality of the femur. The strain concentrated on the cyst. Vascularized greater trochanter bone flap eliminated the strain concentrations, as well improved and regained biomechanical states. Conclusions： Vascularized greater trochanter bone flap is safe and effective in treating ANFH.

关 键 词：股骨头坏死 生物力学 大转子 骨瓣 三维有限元 

分 类 号：R681.805[医药卫生—骨科学] R681.8[医药卫生—外科学]