股骨近端防旋髓内钉治疗高龄非解剖复位股骨颈基底部骨折的有限元分析  

Finite element analysis of proximal femoral nail anti-rotation in the treatment of non-anatomical reduction of basicervical femoral neck fracture in elderly

作　　者：涂世杰 邹洋 熊赵平 陈心敏 林梓凌[2] 邹霞 TU Shijie;ZOU Yang;XIONG Zhaoping;CHEN Xinmin;LIN Ziling;ZOU Xia(Department of Traumatic Orthopedics,Fengcheng Hospital of Traditional Chinese Medicine,Jiangxi Province,Fengcheng331100,China;Department of Traumatic Orthopedics,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangdong Province,Guangzhou510405,China)

机构地区：[1]江西省丰城市中医院创伤骨科,江西丰城331100 [2]广州中医药大学第一附属医院创伤骨科,广东广州510405

出　　处：《中国医药导报》2020年第15期71-75,F0003,共6页China Medical Herald

基　　金：国家自然科学基金面上项目(81673996)。

摘　　要：目的运用有限元法探讨股骨近端防旋髓内钉治疗3种不同复位状态高龄股骨颈基底部骨折的生物力学。方法基于志愿者髋部CT资料,通过Mimics、Geomagic等软件提取和优化股骨近端模型,再导入Solidworks软件中与股骨近端防旋髓内钉进行装配并分割模拟骨折线,移动骨折块分别得到3个不同复位状态的模型(阳性支撑、中性支撑、阴性支撑),最后把3个模型全部导入Abaqus软件中设置材料参数、边界条件等后进行运算,查看模型的Von Mises云图。结果阳性支撑骨折端应力分布最均匀且骨折端位移最小,阴性支撑骨折端应力集中且骨折端移位最大,中性支撑应力分布较均匀且骨折端移位稍大。结论运用股骨近端防旋髓内钉治疗股骨颈基底部骨折,应避免阴性支撑复位状态,尽量维持解剖复位或阳性支撑。Objective To investigate the biomechanics of proximal femoral nail anti-rotation in the treatment of femoral neck basicervical fracture in elderly with three different reduction states by using finite element method.Methods Based on the CT data of the volunteers′hips,the proximal femoral model was extracted and optimized by Mimics,Geomagic and other softwar,then assembled with proximal femoral nail anti-rotation in Solidworks software and segmented into simulated fracture lines.Three models of different reduction states(positive support fracture,neutral support fracture,negative support fracture)were obtained by moving fracture fragments.Finally,all the three models were imported into Abaqus software to set material parameters,boundary conditions,etc.,and then the calculation was carried out to check the Von Mises nephogram of the model.Results The stress distribution of the positive support fracture end was the most uniform and the displacement of the fracture end was the least.The stress of negative support fracture end was concentrated and the displacement of the fracture end was the greatest.The stress distribution of neutral support fracture end was uniform and the displacement of the fracture end was larger.Conclusion The use of proximal femoral nail anti-rotation in the treatment of basicervical femoral neck fracture should avoid the negative support reduction state,and try to maintain the anatomical reduction or positive support.

关 键 词：股骨近端防旋髓内钉 股骨颈基底部骨折 阳性支撑 有限元 

分 类 号：R459[医药卫生—治疗学] R318[医药卫生—临床医学]