股骨近端防旋髓内钉不同进钉点治疗外侧壁破裂型股骨转子间骨折的有限元分析  

Finite element analysis for the treatment of lateral wall fractured femoral intertrochanteric fractures with the different entry points of proximal femoral nail antirotation

作　　者：蔡群斌[1] 姜自伟[1] 林梓凌[1] 陈心敏 董航[1] 黄培镇[1] CAI Qun-bin;JIANG Zi-wei;LIN Zi-ling;CHEN Xin-min;DONG Hang;HUANG Pei-zhen(Department of Orthopaedics,the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine,Guangzhou 510405,China;the First Clinical Medical College of Guangzhou University of Traditional Chinese Medicine)

机构地区：[1]广州中医药大学第一附属医院一骨科,510405 [2]广州中医药大学第一临床医学院

出　　处：《天津医药》2020年第2期105-109,I0003,I0004,共7页Tianjin Medical Journal

基　　金：国家自然科学基金面上资助项目(81673996);广州中医药大学第一附属医院“创新强院”临床研究专项项目(2019IIT11)。

摘　　要：目的运用有限元法探讨股骨近端防旋髓内钉(PFNA)不同进钉点治疗外侧壁破裂型股骨转子间骨折的生物力学。方法基于志愿者髋部CT资料,通过Mimics、Geomagic等软件提取和优化右侧股骨三维模型,导入Solidworks软件中与PFNA模型装配不同进钉点并分割模拟不同外侧壁骨折线得到3个A模型(股骨外侧壁粉碎,内侧支撑存在)和3个B模型(股骨外侧壁粉碎,内侧支撑缺失),导入Abaqus软件中设置材料参数、边界条件等后运算,查看模型的Von Mises云图。结果A模型中外侧壁上部进钉形成应力集中,中部进钉移位较大,下部进钉应力分布均匀且移位较小;B模型外侧壁上部进钉移位较大,中部进钉应力较大且应力集中,下部进钉应力分散且移位较小。结论PFNA在外侧壁下部进钉治疗外侧壁破裂型股骨转子间骨折的生物力学效果最佳。Objective To investigate biomechanics of proximal femoral nail anti-rotation(PFNA)with different entry points in the treatment of lateral wall fracture of femoral intertrochanteric fracture by finite element method.Methods Based on CT data of the hip of volunteers,three-dimensional model of right femur was extracted and optimized by Mimics and Geomagic software.Then,three A models(crushed lateral femoral wall and completed medial femoral wall)and three B models(crushed lateral femoral wall and medial femoral wall)were obtained by assembling different entry points with PFNA model in SolidWorks software and simulating different fracture lines of lateral wall.All the six models were imported into Abaqus software to set material properties and boundary conditions for transportation.The Von Mises cloud pictures of the model were calculated and viewed.Results In model A,the upper entry of the lateral wall formed stress concentration,the middle showed largest displacement and the bottom showed uniform stress distribution and smaller displacement.In model B,the upper entry of the lateral wall showed larger displacement,the middle showed largest stress concentration and the bottom showed smaller stress dispersion and displacement.Conclusion PFNA,which is selected the bottom entry of lateral femoral wall,has the best biomechanical effect in the treatment of lateral wall fracture of femoral intertrochanteric fracture.

关 键 词：股骨近端防旋髓内钉 进钉点 外侧壁破裂 股骨转子间骨折 生物力学 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]