不同固定方式对股骨颈骨折固定效果的影响
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1.上海理工大学;2.上海市普陀区人民医院

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TB333

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上海工程技术研究中心资助项目(18DZ2250900)


Influence of fixation methods on the fixation effect of femoral neck fracture
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1.University of Shanghai for Science and Technology;2.Shanghai Putuo District People'3.'4.s Hospital

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    摘要:

    目的 研究5种不同空间构型的空心螺钉对股骨颈骨折固定效果的影响。方法 将股骨的CT图像,通过逆向重建获得Pauwels Ⅰ、Ⅱ、Ⅲ型股骨颈骨折的几何模型。基于有限元分析软件ANSYS,获取不同内固定方式下,股骨颈头侧、干侧与内固定物的应力分布,以及模型的位移分布。结果 对于Pauwels Ⅰ、Ⅱ、Ⅲ型股骨颈骨折,股骨颈头侧应力峰值最大的分别是倒三角置钉固定方式、两根平行钉固定方式、两根平行钉固定方式;股骨颈干侧应力峰值最大的分别倒三角置钉固定方式、倒三角置钉固定方式、两根平行钉固定方式;内固定物应力峰值最小的均为交叉置钉固定方式;位移峰值最小的分别是强斜置钉固定方式、交叉置钉固定方式、强斜置钉固定方式。结论 交叉置钉的固定方式螺钉变形断裂几率最小,倒三角置钉固定方式可为骨折处提供良好的力学环境。对于Pauwels Ⅰ、Ⅲ型骨折,强斜置钉固定方式预防股骨颈短缩的能力最强,而对于Pauwels Ⅱ型骨折而言,交叉置钉固定方式预防股骨颈短缩的能力最强。

    Abstract:

    Objective To research the influence of five kinds of spatial distributions of hollow screws on the fixation effect of femoral neck fracture. Methods Geometric models of femoral neck fracture with Pauwels type I, II and III were built by reverse engineering according to the CT images of femur. Based on the finite element analysis software ANSYS, the stress distributions of hollow screws, head side and stem side of femoral neck and the displacement distribution of the model were obtained for different fixation methods. Results For femoral neck fracture with Pauwels type I, II and III, the maximum stresses at the head side of femoral neck are the inverted triangle fixation method, two screws parallel fixation method, two screws parallel fixation method, respectively. The maximum stresses at the stem side of femoral neck are the inverted triangle fixation method, inverted triangle fixation method and two screws parallel fixation method, respectively. The minimum stresses on the screws are all the cross fixation method. The minimum displacements of the model are double-supported fixation method, cross fixation method and double-supported fixation method. Conclusion The probability of deformation and fracture of the screw in cross fixation method is the smallest. Inverted triangle fixation method can provide a good mechanical environment for fracture area. For femoral neck fracture with Pauwels type I and III, double-supported fixation method has the strongest ability to prevent femoral neck shortening. While for femoral neck fracture with Pauwels type II, cross fixation method has the strongest ability to prevent femoral neck shortening.

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  • 收稿日期:2018-12-06
  • 最后修改日期:2019-01-21
  • 录用日期:2019-01-28
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