股骨颈骨折空心钉内固定后股骨近端骨质疏松的有限元分析  

Finite element analysis of osteoporosis in proximal femur after cannulated screw fixation for femoral neck fracture

作　　者：薛晓峰[1] 魏永康 乔晓红[1] 杜玉勇 牛建军[1] 任立新[1] 杨慧峰[1] 张治民[1] 郭媛 陈维毅 Xue Xiaofeng;Wei Yongkang;Qiao Xiaohong;Du Yuyong;Niu Jianjun;Ren Lixin;Yang Huifeng;Zhang Zhimin;Guo Yuan;Chen Weiyi(Lvliang People’s Hospital,Lvliang 033000,Shanxi Province,China;College of Biomedical Engineering,Taiyuan University of Technology,Taiyuan 030000,Shanxi Province,China)

机构地区：[1]山西省吕梁市人民医院,山西省吕梁市033000 [2]太原理工大学生物医学工程学院,山西省太原市030000

出　　处：《中国组织工程研究》2024年第6期862-867,共6页Chinese Journal of Tissue Engineering Research

基　　金：山西省科学技术厅基金资助(201903D321150),项目负责人:乔晓红。

摘　　要：背景:股骨颈骨折空心钉内固定术后由于患肢短期内常常不能负重,且高刚度的内植物对骨折断端存在应力遮挡效应,易导致患肢出现骨质疏松,股骨近端生物力学分布发生变化,术后股骨头坏死发病率较高,目前关于股骨颈骨折术后股骨近端骨质疏松对股骨近端及空心钉生物力学影响的研究较少。目的:通过有限元分析探讨股骨颈骨折术后发生骨质疏松对空心钉内固定治疗的生物力学影响,探究生物力学因素在股骨头坏死进程中的作用。方法:获取1例股骨颈骨折患者股骨CT扫描数据,利用Mimics 19.0、3-Matic、UG 11.0、Hypermesh 14.0、Abaqus软件建立空心钉治疗股骨颈骨折的股骨近端模型,利用Abaqus软件分析1种术后股骨近端无骨质疏松、3种术后股骨近端骨质疏松的有限元模型,测量分析4种模型不同部件的应力、接触压力、位移峰值及云图,对比分析股骨头内部应力变化及分布情况。结果与结论:股骨头及下前空心钉的应力、接触压力随骨质疏松程度变化较大,4种模型的位移峰值随着骨质疏松程度加重而缓慢增长。通过单因素方差分析,结果显示骨质疏松程度对不同部件的应力、接触压力、位移峰值无显著性影响,股骨头内部应力分布随骨质疏松发生相应变化,股骨近端的生物力学环境变化对股骨头坏死有着重要影响。BACKGROUND:After the internal fixation of cannulated screws in femoral neck fractures,because the affected limb is often unable to bear weight in the short term and the implants with high stiffness have a stress shielding effect on the fracture end,it is easy to cause osteoporosis of the affected limb and changes in the biomechanical distribution of the proximal femur,the incidence of osteonecrosis of the femoral head is high after surgery.At present,few studies have been conducted on the biomechanical effects of osteoporosis at the proximal end of the femur occurring after femoral neck fracture surgery on femoral neck fracture treated with cannulated screws.OBJECTIVE:Using finite element analysis,to investigate the biomechanical effects of osteoporosis occurring after femoral neck fracture surgery on femoral neck fracture treated with cannulated screws and explore the role of biomechanical factors in osteonecrosis of the femoral head.METHODS:Based on the obtained CT scan data of the femur in a patient with a femoral neck fracture,a proximal femoral model for internal fixation for femoral neck fracture was established by Mimics 19.0,3-Matic,UG 11.0,Hypermesh 14.0,and Abaqus software.One finite element model of the proximal femur without osteoporosis and three finite element models of the proximal femur with osteoporosis were analyzed using Abaqus software.The stress,contact pressure,displacement peak and cloud map under different components of the four models were measured and analyzed,and the internal stress changes and distribution of the femoral head were compared and analyzed.RESULTS AND CONCLUSION:The stresses and contact pressures of the femoral head and lower anterior cannulated screws varied more with the degree of osteoporosis.The peak displacement of the four models increased slowly with the degree of osteoporosis.By one-way analysis of variance,there was no significant effect of the degree of osteoporosis on the peak stress,contact pressure,and displacement of the different components.The internal stre

关 键 词：股骨 股骨颈骨折 空心钉 内固定术 骨质疏松 股骨头坏死 生物力学 有限元 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R683