股骨颈动力交叉钉系统主钉位置对股骨颈骨折稳定性影响的有限元分析  

Finite element analysis of the influence of main screw position of femoral neck system on the stability of femoral neck fracture

作　　者：陈纪宝[1] 盈梅 周磊 章海霞[1] 郭蒙 宋其雨 张振龙 管士伟[1] CHEN Ji-bao;YING Mei;ZHOU Lei;ZHANG Hai-xia;GUO Meng;SONG Qi-yu;ZHANG Zhen-long;GUAN Shi-wei(Dept of Orthopaedics,the First People′s Hospital of Tai′an City,Tai′an,Shandong 271000,China)

机构地区：[1]泰安市第一人民医院骨科,山东泰安271000 [2]山东第一医科大学第二附属医院消化科,山东泰安271000

出　　处：《临床骨科杂志》2023年第5期739-744,共6页Journal of Clinical Orthopaedics

摘　　要：目的采用有限元方法分析股骨颈动力交叉钉系统(FNS)中主钉位置对PauwelsⅢ型股骨颈骨折稳定性的影响。方法选择1名25岁健康男性志愿者,CT扫描收集其股骨中上段影像学数据并建立PauwelsⅢ型股骨颈骨折三维模型,同时建立FNS模型,将两种模型组合并根据FNS主钉位置的不同得到模型1(FNS主钉置入点位于股骨颈轴位中前1/3)、模型2(FNS主钉置入点位于股骨颈轴位中心)、模型3(FNS主钉置入点位于股骨颈轴位中后1/3)。采用有限元分析法评估并比较每组模型中的股骨颈骨折远端和近端、股骨近端、内固定装置的应力情况,同时分析股骨头远端和近端及内固定装置远端和近端在X(平行于股骨颈轴线)、Y(股骨颈矢状位)、Z(垂直于股骨颈轴线)轴位移情况。结果①3组模型股骨颈骨折端及股骨近端的应力随压力的增加均逐渐增加,3组模型间应力比较差异无统计学意义(P>0.05)。②随着压力的增加内固定装置的应力逐渐增加,模型1及模型2均小于模型3(P<0.05)。③3组模型不同压力下股骨头远、近端以及内固定装置远、近端在X轴及Z轴方向位移比较差异均无统计学意义(P>0.05);在Y轴方向位移中,模型3均大于模型1和模型2(P<0.05),模型1与模型2比较差异均无统计学意义(P>0.05)。结论FNS主钉置入点位于股骨颈轴位中心及偏前具有较好的抗旋转能力且能避免内固定装置应力集中,从而使股骨颈骨折固定更牢靠。Objective To analyze the effect of main screw position of femoral neck system(FNS)on the stability of Pauwels typeⅢfemoral neck fracture by using finite element method.Methods A 25-year-old healthy male volunteer was selected to perform CT scan to collect the imaging data of the middle and upper segment of the femur.The three-dimensional model of femoral neck fracture of Pauwels typeⅢwas established,and the FNS model was established at same time.The two models were combined and according to the different positions of FNS main screws,model 1(the inserting point of FNS main screw was located at the medial-anterior 1/3 of the femoral neck axis),model 2(the inserting point of FNS main screw was located at the center of the femoral neck axis),and model 3(the inserting point of FNS main screw was located at the medial-posterior 1/3 of the femoral neck axis)were obtained.Finite element analysis was used to evaluate and compare the stress situation of the distal-proximal of femoral neck fracture,the proximal of femur and the internal fixation device in the each model,and the displacement of the distal and proximal of the femoral head and the internal fixation device on the X,Y and Z axes(the X-axis is parallel to the axis of the femoral neck,the Y-axis is the sagittal of femoral neck,and the Z-axis is perpendicular to the axis of the femoral neck)were analyzed.Results①The stress of femoral neck fracture end and the proximal of femur in the 3 models were gradually increased with the increase of pressure,and there were no statistical differences in stress among the 3 models(P>0.05).②With the increase of pressure,the stress of the internal fixation device were gradually increased,and model 1 and model 2 were both smaller than model 3(P<0.05).③Under different pressures in the 3 models,there were no statistical differences for the displacement of the distal-proximal of the femoral head and internal fixation device on the X-axis and Z-axis directions(P>0.05).In the displacement of Y-axis direction of femoral neck,mod

关 键 词：股骨颈动力交叉钉系统 股骨颈骨折 内固定系统 有限元分析 生物力学 

分 类 号：R683.42[医药卫生—骨科学] R687.32[医药卫生—外科学] R318.01[医药卫生—临床医学]