3种内固定方式治疗青壮年股骨颈骨折的有限元分析  

Finite element analysis of three internal fixation methods for femoral neck fracture in young adults

作　　者：马季 张玉强 智晓东 王伟 MA Ji;ZHANG Yu-qiang;ZHI Xiao-dong;WANG Wei(Dept of Orthopaedics,the First Affiliated Hospital of Jinzhou Medical University,Jinzhou,Liaoning 121001,China;Key Laboratory of Medical Tissue Engineering of Liaoning Province,Jinzhou,Liaoning 121000,China;Institute of Orthopaedics of Jinzhou Medical University,Jinzhou,Liaoning 121000,China)

机构地区：[1]锦州医科大学附属第一医院骨科,辽宁锦州121001 [2]辽宁省医学组织工程重点实验室,辽宁锦州121000 [3]锦州医科大学骨外科学研究所,辽宁锦州121000

出　　处：《临床骨科杂志》2023年第6期890-895,共6页Journal of Clinical Orthopaedics

基　　金：锦州医科大学校企合作基金项目(编号:2020002、2021004)。

摘　　要：目的通过有限元分析比较4枚空心拉力螺钉、动力髋螺钉+防旋螺钉(DHS+DS)和股骨颈动力交叉钉系统(FNS)治疗青壮年PauwelsⅢ型股骨颈骨折的生物力学性能。方法将1名健康成年志愿者的股骨CT数据导入Mimics 21.0软件中构建正常股骨三维模型,建立PauwelsⅢ型股骨颈骨折内固定的有限元模型。比较4枚空心拉力螺钉、DHS+DS、FNS 3种内固定模型中股骨近端骨折块与3种内固定模型的应力分布及峰值、位移分布及峰值,以及骨折断端骨折面的位移分布及峰值。结果①3种内固定模型中股骨近端骨折块的最大应力集中在股骨距附近,最大位移均位于股骨顶端偏上部位,应力峰值及位移峰值FNS模型>4枚空心拉力螺钉模型>DHS+DS模型。②3种内固定模型的应力主要集中在骨折线部位所对应的内固定装置中间部位,应力峰值FNS模型>DHS+DS模型>4枚空心拉力螺钉模型;位移主要集中在对应内固定装置的近端,位移峰值4枚空心拉力螺钉模型>FNS模型>DHS+DS模型。③3种内固定模型骨折断端骨折面的位移主要集中在骨折断端上部,位移峰值FNS模型>4枚空心拉力螺钉模型>DHS+DS模型。结论在3种内固定模型治疗青壮年PauwelsⅢ型股骨颈骨折的有限元分析中,4枚空心拉力螺钉模型的应力峰值最小,但股骨近端骨折块应力和位移峰值均大于DHS+DS模型;DHS+DS模型的生物力学稳定性能优于4枚空心拉力螺钉及FNS模型。Objective To compare the biomechanical properties of 4 cannulated lag screws,dynamic hip screws plus anti-rotation screws(DHS+DS)and femoral neck system(FNS)in the treatment of young adults with Pauwels type-Ⅲfemoral neck fractures by using finite element analysis.Methods The femur CT data of a healthy adult volunteer was imported into Mimics 21.0 software to construct a three-dimensional model of normal femur,and the finite element model of internal fixation of Pauwels type-Ⅲfemoral neck fracture was established.The stress distribution and its peak value,displacement distribution and its peak value,displacement distribution and its peak value of fracture surface at fracture broken end were compared between the fracture fragments of proximal femur of three internal fixation models of 4 cannulated lag screws,DHS+DS,FNS and three kinds of internal fixation models.Results①In the three kinds of internal fixation models,the maximum stress of proximal femoral fracture fragments were concentrated near the femoral calcaneus,and the maximum displacement was located at the upward part of the femoral top.The peak value of the stress and displacement were FNS model>4 cannulated lag screw model>DHS+DS model.②The stress of three internal fixation models were mainly concentrated at the middle part of the internal fixation device corresponding to the fracture line,the peak value of stress was FNS model>DHS+DS model>4 cannulated lag screw models.The displacement was mainly concentrated at the proximal of the corresponding internal fixation device,and the peak value of displacement was 4 cannulated lag screws model>FNS model>DHS+DS model.③The displacement of fracture surface of the fracture broken end of three internal fixation models were mainly concentrated at the upper part of the fracture end,and the peak value of displacement was FNS model>4 cannulated lag screws model>DHS+DS model.Conclusions In the finite element analysis of three internal fixation models for treatment of Pauwels type-Ⅲfemoral neck fracture in y

关 键 词：股骨颈骨折 PauwelsⅢ型 4枚空心拉力螺钉 动力髋螺钉+防旋螺钉 股骨颈动力交叉钉系统 有限元分析 生物力学 

分 类 号：R683.42[医药卫生—骨科学] R[医药卫生—外科学]