青少年股骨近端生长板应力分布的有限元分析  

Finite element analysis of stress distribution of proximal femoral growth plate in adolescents

作　　者：蒋一帆 黄靖杰 彭阳 龚啸元 张颖 古凌川 罗江明 杨君君 眭文 汤哲雄 刘佳木 陈光兴 Jiang Yifan;Huang Jingjie;Peng Yang;Gong Xiaoyuan;Zhang Ying;Gu Lingchuan;Luo Jiangming;Yang Junjun;Sui Wen;Tang Zhexiong;Liu Jiamu;Chen Guangxing(Department of Joint Surgery,the First Affiliated Hospital of Army Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学第一附属医院创伤关节外科,重庆400038

出　　处：《中华骨科杂志》2023年第23期1601-1609,共9页Chinese Journal of Orthopaedics

基　　金：重庆市自然科学基金创新发展联合基金重点项目(2022NSCQ-LZX0256)。

摘　　要：目的探讨力学因素对生长板形态和股骨近端发育的影响,为凸轮型(Cam)髋臼股骨撞击症发生机制提供力学依据。方法利用青少年股骨近端正常及延长型生长板的髋部CT扫描数据仿生构建正常和延长型两种股骨近端骨骺生长板的三维有限元模型。采用Vicon系统收集5名健康志愿者的日常活动(行走、单或双脚站立、上下楼梯、坐下起立和蹲下起立)及篮球训练上篮动作的动态力学和位置数据,选取最大峰值、动作起始与终止的股骨头力学负荷和位置的均值进行有限元力学分析,观察不同活动模式下两种模型生长板上等效应力、法向应力和剪切应力的分布。结果成功构建正常和延长型的股骨近端骨骺生长板的髋关节三维有限元模型,并获得日常活动和上篮动作中股骨头的力学负荷值和空间位置参数。日常活动中,正常与延长型两种模型骨骺生长板的等效应力峰值为1.6~11.0 MPa、压应力(1.7~12.0 MPa)、拉应力(0.5~10.0 MPa)和剪切应力(0.4~7.1 MPa),行走、单或双脚站立、上下楼梯、坐下起立和蹲下起立的压应力集中分布在中央及外侧区域、拉应力集中分布在中央及内侧区域,切应力集中在内侧区域及生长板前后侧边缘。在上篮动作中,正常模型生长板中央、外上侧及内侧边缘的区域压应力明显集中,峰值分别波动在5.5~19.0 MPa、5.7~11.0 MPa、5.4~7.3 MPa。拉应力与切应力在内外边缘及中央区域集中,峰值分别是3.0~24.0 MPa、3.0~26.0 MPa,均与日常活动下的应力分布有明显差异;延长型的生长板可见中央、外侧边缘区域压应力集中,峰值分别波动在17.0~41.0 MPa、17.0~38.0 MPa,模拟的延长部分剪切应力、拉应力较集中峰值波动在4.9~34.0 MPa,同样与日常活动应力分布有明显差异。结论力学分布在日常活动和篮球上篮训练及正常型与延长型生长板间的差异,可能是延长型生长板发育和Cam型髋臼股�ObjectiveTo explore the effects of mechanical factors on the morphology of the growth plate and proximal femur development,in order to provide a mechanical basis for the mechanism of Cam lesions in femoral acetabular impingement(FAI).MethodsUsing CT scan data of hip joint from adolescents,we constructed three-dimensional finite element models of normal and extended proximal femoral epiphyseal growth plates.Dynamic mechanics and position data from daily activities(walk,stand on one and two feet,go upstairs and downstairs,sit and stand up,squat and stand up)and basketball layup drills were collected from five healthy volunteers using the Vicon system.The mean values of femoral head mechanical loads and positions at peak values,movement onset,and termination were selected for finite element analysis to observe the distribution of equivalent stress,normal stress,and shear stress on the two growth plate models under different activity modes.ResultsSuccessful construction of three-dimensional finite element models for normal and extended proximal femoral epiphyseal growth plates was achieved.Mechanical load values and spatial positions of the femoral head during daily activities and layup movements were obtained.In daily activities,peak equivalent stress values for normal and extended growth plates ranged from 1.6 to 11.0 MPa;compressive stress ranged from 1.7 to 12.0 MPa;tensile stress ranged from 0.5 to 10.0 MPa;and shear force ranged from 0.4 to 7.1 MPa.The compressive stress during walking,standing on one or both feet,going up and down stairs,sitting and standing,and squatting was concentrated in the central and lateral areas;tensile stress was concentrated in the central and medial areas;shear force was concentrated in the medial area and the anterior and posterior edges of the growth plate.During a layup,the compressive stress in the center,outer upper side,and medial edge of the growth plate of the normal model was notably concentrated,with peaks fluctuating between 5.5-19.0 MPa,5.7-11.0 MPa,and 5.4-7.3 MPa resp

关 键 词：青少年 股骨髋臼撞击征 骨骺 应力 物理 有限元分析 

分 类 号：R681.8[医药卫生—骨科学]