对不同构型空心拉力钉影响PauwelsⅢ型股骨颈骨折稳定性的有限元分析  

Finite element analysis of the effect of different configurations of cannulated screw on the stability of Pauwels type Ⅲ femoral neck fractures

作　　者：陈纪宝[1] 管士伟[1] 庞涛[1] 周峰 赵爱娜 盈梅 周磊 Chen Jibao;Guan Shiwei;Pang Tao;Zhou Feng;Zhao Aina;Ying Mei;Zhou Lei(Department of orthopedics,the First People's Hospital of Taian,Taian 271000,China)

机构地区：[1]山东省泰安市第一人民医院骨科,271000 [2]山东第一医科大学附属第二医院消化科,泰安271000

出　　处：《骨科临床与研究杂志》2023年第4期234-240,共7页Journal Of Clinical Orthopedics And Research

摘　　要：目的 采用三维有限元方法对3种不同空心拉力螺钉构型治疗PauwelsⅢ型股骨颈骨折的稳定性进行分析。方法 选择来自山东省泰安市第一人民医院骨科的1名25岁健康男性志愿者,行股骨近端CT薄层扫描,利用医学三维重建软件Mimics 19.0、Geomagic Wrap 2017软件、Solidworks 2017软件建立PauwelsⅢ型股骨颈骨折三维模型。构建三种不同排布方式的内固定空心螺钉固定模型:三枚空心螺钉倒三角平行植入(模型1),三枚空心螺钉倒三角头端外展植入(模型2)和三枚空心螺钉倒三角头端内聚植入(模型3)。在ANSYS 17.0有限元软件中进行不同模型应力大小的数据计算,分析各模型中股骨颈骨折断端及股骨近端应力分布情况、应力值大小和不同平面的位移情况,从而分析不同类型固定情况下骨折断端的稳定性。结果 模型2中股骨颈骨折远近端应力差值最大,模型1最小。模型3中股骨头可承受压力最小,模型1与模型2无明显差距。模型2中内固定物平均应力随压力增加其应力增加幅度最小。不同压力条件下模型2在不同轴线的位移较其他两种模型小。结论 3枚空心螺钉不同构型植入治疗PauwelsⅢ型股骨颈骨折时,外展植钉分布表现出来良好的支撑、抗内翻、抗旋转应力作用,但滑动加压作用较平行植钉时差,内聚植钉时骨折整体稳定性最差。因此,空心钉治疗股骨颈骨折时并非必须平行植入,但应避免螺钉内聚型植入。Objective To investigate the three different configuration of cannulated screw in the treatment of Pauwels Ⅲ femoral neck fractures by the finite element method.Methods The CT imaging data of the femur of a 25 years old and healthy volunteer in Department of orthopedics,the First People's Hospital of Taian were selected and imported into the medical three-dimensional reconstruction software Mimics 19.0 to obtain the original three-dimensional model of the femur.The model was exported to an STL format file and imported into the Geomagic Wrap 2017 software for optimization so as to construct femoral cortical bone and cancellous bone structure.The optimized model was imported into Solidworks 2017 software,and the 3D model of Pauwels type Ⅲ femoral neck fractures was reconstructed.Also,Solidworks 2017 software was used to establish the CCS model according to the clinical internal fixation size,and combined with the femoral neck fracture model to establish three different configuration of CCS treatment models.Accoding to configuration,the main CCS implantation point located parallel was model 1,the main CCS implantation point located divergent was model 2 and the main CCS implantation point located cohesion was model 3.Finally,ANSYS 17.0 software was used for meshing.After applying load and data calculation,the stress distribution,peak stress and maximum displacement of femur and internal fixation were analyzed in each model.Results The stress difference between the proximal and distal ends of femoral neck fracture in model 2 was the largest,and that in model 1 was the smallest.The femoral head can bear the least pressure in model 3,and there is no significant difference between model 1 and model 2.The average stress of the internal fixture increases with the increase of pressure,and the increase of stress is the smallest in model 2.Under different pressure conditions,the displacement of model 2 in different axes is smaller than that of the other two models.Conclusion When three cannulated screws with different co

关 键 词：股骨颈骨折 内固定器 有限元分析 生物力学现象 螺钉 

分 类 号：R687.3[医药卫生—骨科学]