四种不同内固定方式治疗Pauwels Ⅲ型股骨颈骨折的有限元分析  

Finite element analysis of four different internal fixation methods for treatment of Pauwels type III femoral neck fractures

作　　者：鲁建鹏 陈龙[1] 乐佳迪 章建雄 Lu Jianpeng;Chen Long;Le Jiadi;Zhang Jianxiong(Affiliated Second Hospital,Wenzhou Medical University,Wenzhou 325000,Zhejiang Province,China)

机构地区：[1]温州医科大学附属第二医院,浙江省温州市325000

出　　处：《中国组织工程研究》2025年第21期4401-4406,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:PauwelsⅢ型股骨颈骨折可能承受更多的剪切力与弯曲力,因此容易发生内固定失效、骨不连或股骨头坏死等并发症,目前关于选择理想的内固定装置还没有达成共识。目的:通过有限元分析比较4种内固定方法治疗PauwelsⅢ型股骨颈骨折的生物力学特性。方法:选取一名健康年轻志愿者的股骨CT数据导入Mimics软件,构建正常股骨的三维模型。根据70°骨折线模拟PauwelsⅢ型股骨颈骨折,使用Geomagic和UG软件优化和构建4种骨折内固定模型:倒三角空心钉、股骨颈固定系统、股骨颈固定系统+空心钉(前)、股骨颈固定系统+空心钉(后)。最后利用Ansys软件分析4种不同内固定模型中股骨近端骨折块的应力分布、峰值应力和峰值位移;观察内固定装置和股骨颈骨折上断面的位移分布和峰值位移。结果与结论:(1)4组骨折近端碎片应力峰值集中在骨折线附近,峰值应力股骨颈固定系统组最大,倒三角空心钉组最小;(2)骨折碎片峰值位移均位于股骨头顶部,峰值位移倒三角空心钉组最大,股骨颈固定系统+空心钉(后)组最小;(3)内固定模型峰值位移均位于模型顶部,峰值位移倒三角空心钉组最大,股骨颈固定系统+空心钉(后)组最小;(4)断裂面的位移在断裂端的上部,峰值位移倒三角空心钉组最大,股骨颈固定系统+空心钉(后)组最小;(5)提示与其他3种内固定方式相比,股骨颈固定系统+空心钉(后)组表现出良好的生物力学稳定性;当PauwelsⅢ型股骨颈骨折发生于年轻人时,从有限元分析的角度,使用其治疗PauwelsⅢ型股骨颈骨折可能是更有利的选择。BACKGROUND:Pauwels type III femoral neck fractures may be subjected to more shear and bending forces,and may be prone to complications such as internal fixation failure,bone nonunion,or femoral head necrosis.There is no consensus on the optimal selection of internal fixation devices.OBJECTIVE:To compare the biomechanical properties of four types of internal fixation methods for Pauwels type III femoral neck fracture by finite element analysis METHODS:Femur CT data of a healthy young volunteer were imported into Mimics software to construct a three-dimensional model of normal femur.Pauwels type III femoral neck fracture was simulated based on 70°fracture line.Four types of fracture internal fixation models were optimized and constructed using Geomagic and UG software:conventional inverted triangle hollow screw,femoral neck fixation system,femoral neck fixation system plus anterior or posterior hollow screw treatment.Finally,Ansys software was used to analyze the stress distribution,peak stress,and peak displacement of proximal femur fracture in four types of different internal fixation models.The displacement distribution and peak displacement of internal fixation device and femoral neck block in four types of different internal fixation models.The displacement distribution and peak displacement of internal fixation device and femoral neck fracture were observed.RESULTS AND CONCLUSION:(1)The peak stress of proximal fracture fragments in the four groups was concentrated near the fracture line.The peak stress in the femoral neck fixation system group was the largest,and that in the conventional inverted triangle hollow screw group was the smallest.(2)The peak displacement of fracture fragments was located at the top of the femoral head.The peak displacement of the conventional inverted triangle hollow screw group was the largest,and that in the femoral neck fixation system+hollow screw(posterior)group was the smallest.(3)The peak displacement of the internal fixation model was located at the top of the model.The pe

关 键 词：股骨颈骨折 股骨颈固定系统 空心螺钉 PauwelsⅢ型骨折 有限元分析 生物力学 

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