股骨颈动力交叉钉系统固定Pauwels Ⅲ型股骨颈骨折头钉不同置入位置的有限元分析  

Finite element analysis of different placements of the head nail in the treatment of Pauwels type Ⅲ femoral neck fracture with the femoral neck system

作　　者：姬帅 马腾[2] 王谦[2] 路遥[2] 张聪明[2] 许毅博 黄强[2] 杜兵 李明[2] 任程[2] 张堃[2] 李忠[2] JI Shuai;MA Teng;WANG Qian;LU Yao;ZHANG Cong-ming;XU Yi-bo;HUANG Qiang;DU Bing;LI Ming;REN Cheng;ZHANG Kun;LI Zhong(Medical College of Yan’an University,Yan’an,Shaanxi,716000,China)

机构地区：[1]延安大学医学院,陕西716000 [2]西安交通大学医学院附属红会医院创伤骨科,陕西710054

出　　处：《中国骨与关节杂志》2023年第3期210-215,共6页Chinese Journal of Bone and Joint

摘　　要：目的 通过有限元分析方法,比较股骨颈动力交叉钉系统(femoral neck system,FNS)内固定治疗PauwelsⅢ型股骨颈骨折时,头钉不同置入位置抵抗髋内翻的生物力学差异,从而为临床手术提供依据。方法 收集人体股骨CT扫描数据,将其导入到Mimics 21.0软件中得到原始模型,在Geomagic 2017软件中进行精细处理,在将其导入Solidworks 2017软件中并按照临床内植物尺寸大小将内固定模型置入股骨模型中,分为两种置入位,A.动力棒组:动力棒正侧位居股骨颈中央;B.头钉组:头钉夹角中线正侧位居股骨颈中央。最后使用ANSYS软件进行划分网格、材料赋值和数据计算等,比较FNS动力棒两种位置置入时股骨及内固定物的应力和位移情况。结果 负荷加载后,两组模型股骨应力峰值分别为40.91 MPa和54.4 MPa,两组模型股骨的位移峰值分别为3.06 mm和3.56 mm,两组模型股骨头的应力峰值分别为8.18 MPa和6.13 MPa,两组模型内固定物的应力峰值分别为3.06 MPa和3.56 MPa,两组模型内固定物位移峰值分别为2.79 mm和2.90 mm。结论 FNS动力棒居股骨颈中央整体力学稳定性优于头钉整体居股骨颈中央,术后出现髋内翻、内固定失效的风险更低。Objective The finite element analysis method was used to compare the biomechanical differences in the resistance of coxa varus in different placement positions of head nails in the treatment of Pauwels Ⅲ femoral neck fractures with the Femoral Neck System( FNS), so as to provide a basis for clinical surgery. Methods The CT scan data of human femur were collected and imported into Mimics 21.0 software to obtain the original model,which was finely processed in Geomagic 2017 software. All data were imported into Solidworks 2017 software,and the internal fixation model was placed in the femur according to the size of clinical implants. In the model, two placement positions were included: A, power rod group, the power rod was placed in the center of the femoral neck;B, head nail group, the midline of the angle between the head nails was in the center of the femoral neck. Finally, the ANSYS software was used to divide the network steps such as grid, material assignment and data calculation. The stress and displacement of the femur and internal fixation when the FNS power rod was placed in two positions were compared. Results After loading, the peak stress of the femurs of the two groups of models were 40.91 and 54.4 MPa,respectively;the peak displacements of the femurs of the two groups of models were 3.06 and 3.56 mm, respectively;the peak stress of the femoral heads of the two groups of models were 8.18 and 6.13 MPa, respectively;the stress peaks of the internal fixtures were 3.06 and 3.56MPa, respectively;the peak displacements of the internal fixtures in the two models were 2.79 and 2.90mm, respectively. Conclusions The overall mechanical stability of the FNS power rod in the center of the femoral neck is better than that of the head screw in the center of the femoral neck, and the risks of coxa varus and internal fixation failure after surgery are lower.

关 键 词：股骨颈骨折 有限元分析 骨折固定术 内 

分 类 号：R687.3[医药卫生—骨科学]