三种内固定装置应用于PauwelsⅢ型股骨颈骨折的有限元分析  

Three internal fixation devices used for finite element analysis of Pauwels type III femoral neck fractures

作　　者：齐远博 李建涛[2] 刘道宏[2,3] 陶笙[2,3] 王道峰 吴杰[3] Qi Yuanbo;Li Jiantao;Liu Daohong;Tao Sheng;Wang Daofeng;Wu Jie(Hebei North University,Zhangjiakou 075000,Hebei Province,China;Department of Orthopedics,Chinese PLA General Hospital,Beijing 100853,China;Department of Orthopedics,Eighth Medical Center of Chinese PLA General Hospital,Beijing 100091,China)

机构地区：[1]河北北方学院,河北省张家口市075000 [2]解放军总医院骨科医学部,北京市100853 [3]解放军总医院第八医学中心骨科,北京市100091

出　　处：《中国组织工程研究》2024年第30期4763-4769,共7页Chinese Journal of Tissue Engineering Research

基　　金：国家重点研发计划(2019YFC0840705),合作单位项目负责人:刘道宏。

摘　　要：背景:目前临床上对于PauwelsⅢ型股骨颈骨折的内固定选用仍存在争议,选择提供稳定固定强度的内固定是实现PauwelsⅢ型骨折固定的关键基础。目的:利用三维有限元分析法测试3种类型内固定应用于PauwelsⅢ型股骨颈骨折的生物力学强度差异,为其临床治疗提供借鉴。方法:使用一名健康男性志愿者的左股骨CT数据,在Mimics软件中重建出一个完整的股骨及其骨松质,运用Geomagic studio软件进行逆向建模,并在UG-NX软件中创建出倒三角空心螺钉、动力髋螺钉、股骨颈动力交叉钉系统;将3种内固定模型分别装配至股骨模型上;通过Hypermesh软件模拟PauwelsⅢ型股骨颈骨折;最后应用Abaqus软件进行有限元实验分析,分析比较不同内固定系统固定股骨颈骨折所产生的应力分布、应力峰值、应变情况及位移分布。结果与结论:①股骨近端骨块的应力主要分布在骨折端附近股骨颈下方区域,动力髋螺钉组的应力峰值最大,股骨颈动力交叉钉系统组最小;②内固定装置的应力分布主要集中在骨折线附近的螺钉表面,股骨颈动力交叉钉系统组的应力峰值最大,动力髋螺钉组最小;③股骨近端骨块的主要应变场分布于骨与螺钉接触的上表面区域,股骨颈动力交叉钉系统组的屈服应变最小,倒三角空心螺钉组最大;④内固定装置模型的主要应变场分布于股骨颈螺钉的上表面,股骨颈动力交叉钉系统组的屈服应变最小,倒三角空心螺钉组最大;⑤3种股骨颈骨折内固定模型中的股骨、近端骨块、远端骨块、内固定装置以及内固定与股骨整体的位移分布值均由近端到远端逐渐减小,其中股骨颈动力交叉钉系统固定组的位移峰值最大,动力髋螺钉组最小;⑥结果表明,在固定PauwelsⅢ型股骨颈骨折时,股骨颈动力交叉钉系统的应力分布更为均匀、力学传导特性更好,其承受了较低的屈服应变、较高的应力和较�BACKGROUND:At present,there is still controversy in clinical practice about the choice of internal fixation of Pauwels type III femoral neck fracture,and the selection of internal fixation that provides stable fixation strength is the key basis for achieving Pauwels type III fracture fixation.OBJECTIVE:The three-dimensional finite element analysis method was used to test the difference in biomechanical strength of three types of internal fixation in Pauwels type III femoral neck fracture,which provided a reference for its clinical treatment.METHODS:Using the CT data of the left femur of a healthy male volunteer,a complete femur and its cancellous bone were reconstructed in Mimics software,and Geomagic studio software was used for reverse modeling.Cannulated compression screw,dynamic hip screw,and femoral neck system were created in UG-NX software.Three kinds of internal fixation models were assembled on the femur model,and Pauwels type III femoral neck fracture was simulated by Hypermesh software.Finally,Abaqus software was used to carry out finite element experimental analysis to analyze and compare the stress distribution,stress peak,strain,and displacement distribution caused by fixed femoral neck fracture of different internal fixation systems.RESULTS AND CONCLUSION:(1)The stress of the proximal femur bone mass was mainly distributed in the area below the femoral neck near the fracture end,with the highest stress peak in the dynamic hip screw group and the smallest in the femoral neck system group.(2)The stress distribution of the internal fixation device was mainly concentrated on the screw surface near the fracture line,with the highest stress peak in the femoral neck system group and the smallest in the dynamic hip screw group.(3)The main strain field of the proximal femur bone mass was distributed in the upper surface area where the bone and screw contacted,and the yield strain was the smallest in the femoral neck system group and the largest in the cannulated compression screw group.(4)The main strain fi

关 键 词：骨折 股骨颈骨折 内固定 生物力学 有限元分析 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R496