个体化建模有限元分析对股骨髓内钉术后骨愈合情况随访的应用研究  

Finite element analysis of individualized modeling on bone healing after femoral intramedullary ;nailing：a one-year follow-up study

作　　者：周江军[1] 都承斐[2] 赵敏[1] 吕仁发[1] 黎蕾[1] 杨俊[1] 余专一 

机构地区：[1] 中国人民解放军第184医院骨科,江西鹰潭335000 [2] 北京航空航天大学生物与医学工程学院教育部生物力学与力生物学重点实验室

出　　处：《中华生物医学工程杂志》2015年第1期70-74,共5页Chinese Journal of Biomedical Engineering

基　　金：全军后勤科研计划重点项目（BNJ13J003）;全军医学科技青年培育项目计划（13QNP049）;南京军区医学科技创新课题资助项目（10MA058）

摘　　要：目的：对股骨骨折髓内钉术后1年随访模型快速建模，通过个体化建模有限元方法研究分析，判定内固定取出后骨折断端是否具有断裂的风险。方法10名股骨上段或中段骨折的男性志愿者已行股骨骨折髓内钉术后1年，分为2组，X线判定骨折愈合与否，骨折端骨愈合组5名，骨未愈合组5名，行股骨全长CT扫描后运用Mimics、Geomagic Studio、Abaqus等软件采用快速个体化建模方法建立模型，并模拟取出髓内钉后进行有限元分析，施加人体单腿站立时的静力载荷和约束，并将分析结果进行对比，观察米塞斯应力分布、最大值及其所处部位。结果按照材料属性进行区别显示米塞斯应力的最大值及最小值，骨愈合组：5例病人最大米塞斯应力值均不在骨折断端附近，应力集中区域及应力集中点分布均位于骨愈合区外，骨折断端周围并不是应力集中区域；骨未愈合组：5例病人各类型材料最大米塞斯应力值均位于骨折断端，骨折断端周围是应力集中区域。结论采用个体化建模方法可以对骨折内固定取出前的骨愈合模型进行运算分析，预测骨折畸形愈合下内固定取出后的稳定性，快速预判术后缓慢行走是否导致骨折断端断裂。Objective To rapidly establish the 1-year follow-up model in patients with femoral fracture after intramedullary nailing,and to identify whether there are fracture risks on broken ends of fractured bone after removing internal fixation by finite element analysis of individualized modeling. Methods Ten male volunteers with superior or middle femoral fractures who had underwent femoral intramedullary nailing 1 year before were included in the study. According to whether the fractures were healed,all patients were divided into two groups by X-ray evaluation,the group with healed bone fracture ends and the group with unhealed bone fracture ends（n=5 each）. Rapid and individualized modeling was completed by using Mimics,Geomagic Studio,and Abaqus softwares after CT scanning of the femurs. All the models were processed with finite element analysis after simulated removal of the intramedullary nails. Then,basic load and constraints with a human body standing on one leg were applied on the models and the results were compared. The distribution,maximum value and location of von Mises stress were determined. Results The maximum and minimum values of von Mises stress were distinctively showed based on material properties. In the group with healed bone fracture ends,the maximum values of von Mises stress in 5＆amp;nbsp;patients were not around broken ends of fractured bone;the distributions of the area and point of stress concentration were outside the healed bone area;the peripheral broken ends of fractured bone were not the areas of stress concentration. In the group with unhealed bone fracture,the maximum values of von Mises stress in 5 patients were around the broken ends of fractured bone;the peripheral broken ends of fractured bone were the areas of stress concentration. Conclusion Using individualized modeling may allow for operational analysis on healed bone model before internal fracture fixation is removed,and thereby predict the stability of the model after internal fracture fixation is removed under fracture

关 键 词：有限元分析 生物力学 股骨骨折 髓内钉 骨愈合模型 个体化建模 

分 类 号：R681.8[医药卫生—骨科学]