骨质疏松股骨转子间不稳定型骨折患者人工股骨头置换的三维有限元分析  

Study on the Stress Changes after Artificial Femoral Head Replacement for Unstable Osteoporotic Intertrochanteric Fracture Patients Using Three-dimensional Finite Element Analysis

作　　者：卢申童[1] 冯宗权[1] 邹勇根[1] 刘伟明[1] 潘耀成 LU Shentong;FENG Zongquan;ZOU Yonggen;LIU Weiming;PAN Yaocheng(Osteoarthrosis Department,Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,Guangdong China)

机构地区：[1]广东佛山市中医院骨九科

出　　处：《中国中医骨伤科杂志》2019年第11期19-22,共4页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：广东省中医药局科研课题（20141273）;佛山市卫生和计生局医学科研课题（20180502)

摘　　要：目的:探讨骨质疏松股骨转子间不稳定型骨折患者采用人工股骨头置换治疗的应力变化情况。方法:随机选择在本院接受体检的健康老年男性40例,同期选择转子间骨折股骨头置换组40例,多排螺旋CT扫描左侧股骨,建立股骨假体及人体股骨三维有限元模型。根据机体对楼梯攀爬情况进行模拟,建立三维有限元模型,对假体周围骨性通道、假体、股骨体表等各项力学指标的应力分布状况赋值。结果:正常情况下股骨内外侧受力情况相似,由近端至远端受力逐渐增大是应力变化的结果,假体应力集中在中段部位。股骨整体应力分布不受人工股骨头置换术的影响,根据由近端至远端逐渐增大情况,全长中段股骨部位是应力最大部位,重建后股骨距无应力显著集中情况;观察假体柄前内侧应力情况时发现,其与股骨内松质骨和相应假体应力分布情况变化趋势一致;人工股骨头置换后假体受力变化趋势与正常股骨组、转子间骨折股骨头置换组基本一致,差异无统计学意义(P>0.05)。结论:股骨整体应力分布不受人工股骨头置换术的影响,根据由近端至远端逐渐增大情况,全长中段股骨部位是应力最大部位,重建后股骨距无应力显著集中情况。Objective:To study the stress changes after artificial femoral head replacement for unstable osteoporotic intertrochanteric fracture patients using three-dimensional finite element analysis.Methods:40 healthy elderly male check-ups and 40 intertrochanteric fracture patients were selected.The multi-slice spiral CT scanning was performed in the left femur;three-dimensional finite element model for femoral prosthesis and femur was established.Under the scene stimulation of climbing stairs,the stress distribution conditions of the osseous channels,prosthesis and femur were analyzed.Results:In the normal state,the internal and external stress of the femur was basically the same.The stress was gradually increased from the proximal and distal femur.The stress of prosthesis was focused on the middle parts.The overall stress distribution patterns were not obviously changed after artificial femoral head replacement.The maximum stress was distributed in the middle femur.After reconstruction,the calcar femorale had no obvious stress.According to the anteromedial stress of prosthesis,the stress of cancellous bone and prosthesis was proven to have the similar variation trend;after model simulation,the stress for normal group and intertrochanteric fracture group had the similar variation trends(P>0.05).Conclusion:After artificial femoral head replacement,the overall stress distribution patterns are not obviously changed.The maximum stress is distributed in the middle femur.After reconstruction,the calcar femorale has no obvious stress.

关 键 词：组织工程 有限元分析 骨质疏松 股骨转子间骨折 

分 类 号：R683.42[医药卫生—骨科学]