股骨颈断端愈合去除空心钉后的有限元分析  

The finite element analysis of the femoral head after repair of the femoral neck fracture and removal of the inserted cannulated screws

作　　者：吴伟[1] 喻爱喜[1] 漆白文[1] 肖卫东[1] 

机构地区：[1]武汉大学中南医院显微骨科,430071

出　　处：《中华实验外科杂志》2015年第7期1590-1592,共3页Chinese Journal of Experimental Surgery

摘　　要：目的 探讨股骨颈骨折断端骨性愈合去除空心钉后股骨头坏死的生物力学因素.方法 利用有限元分析技术分别建立3枚或2枚空心钉固定股骨颈骨折的有限元模型,空心钉平行于股骨颈方向,排列分布处于最集中、最分散及介于两者之间,空心钉远端分别位于股骨头下10、5、2 mm.在相同的加载和约束情况下,通过有限元分析计算比较各模型中内固定去除以后股骨头的受力情况.结果 当3枚空心钉排列分布最集中且远端位于股骨头下2 mm时,去除空心钉后股骨头前外侧的应力值最大,为46.1 mPa;当两枚空心钉排列分布最分散且远端位于股骨头下10 mm时,去除空心钉后股骨头前外侧的应力值最小,为10.3 mPa.结论 空心钉排列分布方式、空心钉远端位于股骨头下深度及数量是股骨颈骨折术后骨折断端骨性愈合去除空心钉后股骨头坏死的生物力学影响因素.国际内固定研究学会（AO）推荐的股骨颈骨折空心钉置入方式在去除空心钉以后对股骨头的生物力学影响最小.Objective To discuss the biomechanics factors which caused osteonecrosis of the femoral head （ONFH） after removal of the cannulated screws inserted in the healing operation of femoral neck fracture.Methods Using the finite element analysis,finite element models with three or two cannulated screws inserted in the healing operation were established respectively.In the models,the directions of inserted cannulated screws and the femoral neck were parallel.The distribution of inserted cannulated screws was the most centralized,the most dispersive and between them.The far-end depth of inserted cannulated screws was 10,5,and 2 mm.Under the same load and constraint,the stresses of the femeral head in different models were compared by the finite element analysis.Results The stress of the femeral head reached to a maximum value of 46.1 mPa when the distribution of three inserted cannulated screws was the most dispersive and their far-end depth was 2 mm.And it reached to a mimimum value of 10.3 mPa when the distribution of two inserted cannulated screws was the most centralized and their far-end depth was 10 mm.Conclusion The distribution,the far-end depth and number of inserted cannulated screws were the biomechanics factors which caused ONFH.This experiment indirectly proved the cannulated screws insert method recommended by international institute for internal fixation （AO） foundation made the least effect to the stress of femeral head after the inserted cannulated screws were removed.

关 键 词：空心钉 股骨头坏死 有限元分析 

分 类 号：R473.6[医药卫生—护理学]