牵引下侧身翻身对股骨颈骨折断端生物力学影响的有限元分析  

Finite Element Analysis of Traction Effect on Femoral Neck Fracture during Body-Turning Nursing

作　　者：李冬妹[1] 黄素珍[1] 陈希聪[1] 高泽伟[1] LI Dongmei;HUANG Suzhen;CHEN Xicong;GAO Zewei(Department of Anesthesia,Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,Guangdong China)

机构地区：[1]广东佛山市中医院麻醉科手术室,广东佛山528000

出　　处：《中国中医骨伤科杂志》2021年第2期19-22,共4页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:采用计算机仿真研究在有牵引与无牵引状态下股骨颈骨折断端在侧身翻身状态下的生物力学差异。方法:选取一老年股骨颈骨折患者髋部CT资料,经过Minics19.0软件重建股骨中上段三维模型,然后在Geomagic Studio软件中进行优化,在Hypermesh14.0软件中划分四面体网格,构建PauwelsⅢ型股骨颈骨折,并设置材料参数及骨折断端摩擦系数,施加牵引载荷及下肢重力载荷,设定边界条件,最后导入LS-DYNA进行运算仿真。结果:在有牵引与无牵引状态下,骨折断端的应力均集中在股骨颈内下方;牵引状态下骨折断端的应力(30.3 MPa)小于无牵引状态下的应力(106.7 MPa),各个方向的分位移及合位移大于无牵引状态下的位移。结论:牵引状态下的侧身翻身可以牵开相互嵌插的骨折端,减小骨折断端的应力,从而可能减少患者的疼痛感受。Objective:To investigate the biomechanical effect of traction in femoral neck fracture during body-turning nursing.Methods:CT image data in DICOM format of bilateral hip was collected from a femoral neck fracture patient.This data was imported in Mimics 19.0 software and outputted as STL format after reconstruction.Geomagic studio 2013 software was used to smooth process.Subsequently,it was imported in Hypermesh 14.0 software for meshing tetrahedral to form a Pauwels Ⅲ femoral neck fracture.Material property and friction coefficient were set.After that,the traction loading and gravitational loading of low lower limb were added,and boundary conditions were established.Finally,this completed finite element model was submitted to LS-DYNA for calculating and simulating.Results:Stress concentrated on the inferior of femoral neck both in traction and non-traction model.Stress around facture site were lower in traction femoral than that in non-traction,but displacement were more significant than that in non-traction model.Conclusion:Traction can retract the intercalated fracture and reduce the compacted stress around fracture site during body-turning,potentially reducing the patient’s experience of pain.

关 键 词：牵引 股骨颈骨折 侧身翻身 生物力学 有限元分析 

分 类 号：R683.42[医药卫生—骨科学]