摘要
目的通过有限元分析不同空间分布固定模型的空心钉内固定治疗股骨颈PauwelsⅠ型骨折的生物力学特性。方法选取2023年陆军军医大学第一附属医院健康体检的男性志愿者1名,经128排螺旋CT对志愿者股骨头至股骨远端进行薄层扫描,初步构建获得符合人体结构的股骨模型。以股骨干中心为参照做垂线,骨折线位于股骨颈中心且与其呈30°夹角,完成股骨颈PauwelsⅠ型骨折模型构建。采用SolidWorks 2021软件建立5种不同空间分布的3枚三角空心钉手术固定模型。空间分布方式分别为倒等边三角形、倒等腰三角形、倒锐角三角形、倒后直角三角形、倒后钝角三角形。将装配模型导入Ansys 2021R1软件,建立有限元模型。记录评估不同空间分布固定模型的股骨模型及内固定物最大应力峰值,分析股骨及内固定物的最大位移。结果不同空间分布固定模型在股骨近端的应力集中区域均位于股骨颈骨折区域下方,其中倒等边三角形构型的应力峰值最小,为18.674 MPa。不同空间分布固定模型内固定物总体的应力均位于股骨近端腹侧螺钉中段区域,其中倒等边三角形构型的应力峰值最小,为46.484 MPa。不同空间分布固定模型在股骨颈骨折处总体位移均位于股骨头应力加载部位。其中倒等边三角形构型的位移最小,为0.72517 mm。不同空间分布固定模型内固定物位移均位于股骨头应力加载部位。其中倒等边三角形构型的位移最小,为0.68933 mm。结论不同空间分布固定模型的空心钉内固定治疗股骨颈PauwelsⅠ型骨折显示出不同的生物力学特性。其中倒等边三角形构型的应力分散能力最强,位移最小,力学稳定性最佳。
Objective To analyze the biomechanical characteristics of hollow nail internal fixation for Pauwels typeⅠfractures of the femoral neck through finite element(FE)analysis by modeling 3 hollow screws located at different spatial distributions.Methods A healthy male volunteer who underwent physical examination in our hospital was selected to undergo thin layer scan of the femoral head to the distal end of the femur using a 128-row spiral CT scanner.Then a femoral model in line with human structure was preliminarily constructed.The femoral shaft center was taken as the reference,a perpendicular line was drawn,and the fracture line was located at the center of the femoral neck at an angle of 30°to construct the model of Pauwels typeⅠfemoral neck fractures.The SolidWorks 2021 software was adopted to establish the fixation model by 3 hollow nails at five different spatial distributions:respectively an inverted equilateral triangle,an inverted isosceles triangle,an inverted acute angle triangle,an inverted right angle triangle,and an inverted obtuse angle triangle.Thereafter,import the assembly model into the Ansys 2021R1 software and establish an FE model.The maximum stress peak of the femur model and internal fixators at different spatial distributions of the 3 screws were evaluated,and the maximum displacement of the femur and internal fixators were analyzed.Results The stress concentration areas in the proximal femur of different screw spatial distributions were all located below the fracture area of the femoral neck,with the stress peak of the inverted equilateral triangle configuration being the smallest,at 18.674 MPa.The overall stress of the fixators in different spatial screw distributions was located in the middle section of the proximal femoral ventral screw,with the stress peak of the inverted equilateral triangle configuration being the smallest,at 46.484 MPa.The overall displacement of different spatial screw distributions at the femoral neck fracture was located at the stress-loading site of the femoral head.The displacement of the inverted equilateral triangle configuration was the smallest,at 0.72517 mm.The displacement of the fixators in different spatial distribution fixation models was located at the stress-loading site of the femoral head.The displacement of the inverted equilateral triangle configuration was the smallest,at 0.68933 mm.Conclusion Hollow screws at different spatial distribution exhibit different biomechanical characteristics in the treatment of Pauwels typeⅠfemoral neck fractures.The inverted equilateral triangle configuration reveals the strongest stress dispersion ability,the smallest displacement,and the best mechanical stability.
作者
朱浩然
肖伟
向强
李科
Zhu Haoran;Xiao Wei;Xiang Qiang;Li Ke(Department of Emergency Medicine,the First Affiliated Hospital,Army Medical University,Chongqing 400038,China;Emergency Department of Chongqing Yongchuan District Hospital of Traditional Chinese Medicine,Yongchuan,Chongqing402160,China)
出处
《创伤外科杂志》
2024年第10期739-744,共6页
Journal of Traumatic Surgery
基金
重庆市卫生适宜技术推广项目(2019jstg024)。
