股骨近端骨缺损与骨折相关性的有限元分析  

Finite Element Analysis on Fracture Relevance as Bone Defect of Proximal Femur

作　　者：张帅[1] 屠重棋[1] 段宏[1] 闵理[1] 周勇[1] 张树良[1] 姜勇[1] 冯品[1] 

机构地区：[1]四川大学华西医院骨科,成都610041

出　　处：《四川大学学报（医学版）》2011年第2期273-276,279,共5页Journal of Sichuan University(Medical Sciences)

基　　金：国家"十一.五"科技支撑计划基金(批准号2007BAE13B04)资助

摘　　要：目的 建立股骨近端不同缺损三维有限元模型,分析研究股骨近端在慢步行走步态周期中的局部应力及应变,估计骨折可能范围,为临床工作提供理论依据。方法 通过CT扫描股骨全长建立股骨近端3种缺损情况下的三维有限元模型,模拟下肢慢步行走负荷加载,分析股骨近端小转子区、转子间区和股骨颈骨缺损的应力变化。结果 ①小转子中点水平的股外侧单皮质缺损为5%～25%时,局部最大应力分别为96.74～179.10 MPa,当缺损≥10%时,局部最大应力均大于极限应力值141 MPa。内侧相对区域最大应力为46.15～62.13 MPa,远小于其屈服应力93 MPa。②转子间水平的股外侧单皮质缺损为5%~25%时,局部最大应力分别达45.70～127.11MPa,均小于极限应力。内侧应力改变同小转子缺损。③股骨颈内侧皮质完整的髓腔球形缺损≤40%时,局部应力均小于屈服应力93 MPa,缺损45%～50%时,局部最大应力分别为100.20 MPa和119.40 MPa,小于极限应力;④破坏内侧皮质1/2的髓腔球形缺损为15%～50%时,局部最大应力为87.79～1270.40 MPa,当缺损≥45%时,局部最大应力大于极限应力。结论 股骨近端外侧皮质缺损,对相应的股骨内侧影响不大;对于小转子水平股骨外侧单皮质缺损,当缺损≤5%相对安全,≥10%时将会出现局部骨折;转子间水平股骨外侧单皮质缺损,缺损≤20%时相对安全,≥25%时存在局部骨折风险;股骨颈内侧皮质完整的髓腔缺损,≤40%时均相对安全,45%～50%有一定的局部骨折风险,但若缺损≥45%而皮质完整特别是前后皮质完整者,其局部骨折风险很小;股骨颈内侧皮质破坏1/2的髓腔内缺损,≤20%时相对安全,≥45%将会出现局部骨折。Objective Based on establishment three-dimensional finite element models with the different defects of proximal femur,analysis of the local stress and strain changes under normal walking condition,speculate the probable rang of fracture and provide a theoretical basis for clinical work.Methods By CT scanning the whole femur,establish Three-dimensional finite element models were established with analogous to the loaded lower extremity under normal walking condition.The stress distribution of the zone of lesser trochanter,intertrochanter and femur neck were analyzed.Results ① To the defects of lateral cortex of proximal femur at lesser trochanter level,defect of 5%-25%,the local maximum stress were up to 96.74-179.10 MPa.When the defect was greater than 10%,the local maximum was greater than the ultimate stress 141 MPa.While,the stresses of medial femur were 46.15-62.13 MPa,which was much lower than that of yielding stress.② At the level of intertrochanter with 5%-25% defect,the stresses were 45.70-127.11 MPa,all of them were lower than that of the ultimate stress.Whereas the changes of stress of medial femur were as the same as the stress at lesser trochanter level.③ When the intramedullary defect of femur neck not involving inner cortex was less 40%,the local stress was lower than yielding stress 93 MPa.When the defects were 45% and 50%,the local maximum stress were up to 100.20 MPa and 119.40 MPa.④ While intramedullary defects of femur neck involving half of medial cortex were 15%-50%,the stress were 87.79-1207.40 MPa.When the defects were above the level of 45%,the local maximum is greater than 141 MPa.ConclusionThe defects in lateral cortex of proximal femur has little influence on the medial cortex at the same level.And have little influence on the strength of femur;If defects located in the lateral cortex of lesser trochanter,5% was relative safe,5%10% was at the risk of fracture,and defects larger than 10% would result in fracture.When defects located in the lateral femur at the level of intertrocha

关 键 词：股骨近端 骨缺损 骨折 有限元分析 

分 类 号：R687.3[医药卫生—骨科学]