股骨转子间骨折术后固定强度的研究  

Postoperative fixation strength of femoral intertrochanteric fractures

作　　者：夏洪刚[1] 宋明智[1] 张亚文 陈秉智 XIA Honggang;SONG Mingzhi;ZHANG Yawen;CHEN Bingzhi(Department of Orthopaedics,The First Affiliated Hospital of Dalian Medical University,Dalian Liaoning 116602,China;不详)

机构地区：[1]大连医科大学附属第一医院骨科,辽宁大连116602 [2]大连交通大学机械工程学院,辽宁大连116028

出　　处：《空军航空医学》2022年第4期148-152,共5页AVIATION MEDICINE OF AIR FORCE

摘　　要：目的通过对新鲜人体尸骨股骨近端髓内钉固定的生物力学有限元分析和实验研究,获得髓内钉植入的最佳位置和术后功能锻炼强度的安全数据。方法选取新鲜人尸体股骨标本,利用Mimics软件完成股骨近端髓内钉置入骨折模型的三维几何重构,并在Hypermesh软件中建立骨折模式的有限元模型,利用Abaqus软件分析髓内钉不同进针点、头颈钉在股骨颈中不同位置的骨折固定效果。模拟同一分型股骨转子间骨折,按不同位置植入髓内钉,建立8种手术实验模型(标号A1-A4,B1-B4)。随后分别在静态试验机和疲劳试验机进行静态压缩和疲劳加载实验,查看固定失效情况。结果髓内钉进针点在股骨转子尖处、头颈钉位于股骨颈中下1/3位置,有限元分析具有良好的生物力学性能;实验时静态承载最大,极限载荷为1665 N;在100万次极限疲劳实验后发生最轻失效。结论选择髓内钉进针点位于大转子尖、头颈钉位于股骨颈中下1/3能获得良好的稳定性,承载最大的静态与疲劳载荷,能进行100万次安全功能锻炼。Objective To obtain the optimal position of intramedullary nail implantation and the data on the safe intensity of postoperative functional exercise.Methods Mimics was used to complete the three-dimensional geometric reconstruction based on human femur specimens before a finite element model of intertrochanteric fractures was established in Hypermesh.Abaqus was used to analyze the fixation effect of both intramedullary nails at different points of insertion and head-neck screws in different femoral neck positions.By simulating the same type of femoral intertrochanteric fracture,intramedullary nails were implanted in different positions to establish eight models for surgical experiments(A1~A4,B1—B4).To find out about the failure of fixation,static compression and fatigue loading experiments were conducted on static and fatigue testing machines respectively.Results The good biomechanical performance by the finite element analysis showed that the best insertion point of intramedullary nails was the tip of the femoral rotor,and the best position of the head-neck screws was at the middle and lower 1/3 of the femoral neck.The ultimate load in static compression was 1665 N.Minimum failure occurred after one million ultimate fatigue tests.Conclusion Good stability,the largest static and fatigue loads and one million times of safe functional exercises can be ensured when the intramedullary nail is inserted through the tip of the greater trochanter and the head-neck screws are locked at the middle and lower 1/3 of the femoral neck.

关 键 词：股骨转子间骨折 髓内钉位置 有限元分析 强度实验 

分 类 号：R274.1[医药卫生—中医骨伤科学]