[1]李冬妹 黄素珍 陈希聪 高泽伟.牵引下侧身翻身对股骨颈骨折断端生物力学影响的有限元分析[J].中国中医骨伤科杂志,2021,29(02):19-22.
　LI Dongmei HUANG Suzhen CHEN Xicong GAO Zewei.Finite Element Analysis of Traction Effect on FemoralNeck Fracture during Body-Turning Nursing[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2021,29(02):19-22.
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牵引下侧身翻身对股骨颈骨折断端生物力学影响的有限元分析()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第29卷
期数:
2021年02期
页码:
19-22
栏目:
临床研究
出版日期:
2021-02-15

文章信息/Info

Title:
Finite Element Analysis of Traction Effect on FemoralNeck Fracture during Body-Turning Nursing
文章编号:
1005-0205(2021)02-0019-04
作者:
李冬妹1 黄素珍1 陈希聪1 高泽伟1
1广东佛山市中医院麻醉科手术室(广东 佛山,528000)
Author(s):
LI Dongmei1 HUANG Suzhen1 CHEN Xicong1 GAO Zewei1
1Department of Anesthesia,Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,Guangdong China.
关键词:
牵引;  股骨颈骨折;  侧身翻身;  生物力学;  有限元分析
Keywords:
traction;  femoral neck fracture;  body-turning;  biomechanics;  finite element analysis
分类号:
R683.42
文献标志码:
A
摘要:
目的:采用计算机仿真研究在有牵引与无牵引状态下股骨颈骨折断端在侧身翻身状态下的生物力学差异。方法:选取一老年股骨颈骨折患者髋部CT资料,经过Minics19.0软件重建股骨中上段三维模型,然后在Geomagic Studio软件中进行优化,在Hypermesh14.0软件中划分四面体网格,构建Pauwels Ⅲ型股骨颈骨折,并设置材料参数及骨折断端摩擦系数,施加牵引载荷及下肢重力载荷,设定边界条件,最后导入LS-DYNA进行运算仿真。结果:在有牵引与无牵引状态下,骨折断端的应力均集中在股骨颈内下方; 牵引状态下骨折断端的应力(30.3 MPa)小于无牵引状态下的应力(106.7 MPa),各个方向的分位移及合位移大于无牵引状态下的位移。结论:牵引状态下的侧身翻身可以牵开相互嵌插的骨折端,减小骨折断端的应力,从而可能减少患者的疼痛感受。
Abstract:
To investigate the biomechanical effect of traction in femoral neck fracture during body-turning nursing.Methods:CT image data in DICOM format of bilateral hip was collected from a femoral neck fracture patient.This data was imported in Mimics 19.0 software and outputted as STL format after reconstruction.Geomagic studio 2013 software was used to smooth process.Subsequently,it was imported in Hypermesh 14.0 software for meshing tetrahedral to form a Pauwels Ⅲ femoral neck fracture.Material property and friction coefficient were set.After that,the traction loading and gravitational loading of low lower limb were added,and boundary conditions were established.Finally,this completed finite element model was submitted to LS-DYNA for calculating and simulating.Results:Stress concentrated on the inferior of femoral neck both in traction and non-traction model.Stress around facture site were lower in traction femoral than that in non-traction,but displacement were more significant than that in non-traction model.Conclusion:Traction can retract the intercalated fracture and reduce the compacted stress around fracture site during body-turning,potentially reducing the patient’s experience of pain.

参考文献/References:

[1] ROGMARK C,LEONARDSSON O.Hip arthroplasty for the treatment of displaced fractures of the femoral neck in elderly patients[J].Bone Joint J,2016,98-B(3):291-297.
[2] 周洋洋,倪英杰,李荥娟,等.老年股骨颈骨折治疗研究进展[J].中国修复重建外科杂志,2019,33(8):1033-1040.
[3] DONEGAN D J,GAY A N,BALDWIN K,et al.Use of medical comorbidities to predict complications after hip fracture surgery in the elderly[J].J Bone Joint Surg Am,2010,92(4):807-813.
[4] 郑利钦,林梓凌,李鹏飞,等.动态载荷下松质骨对骨质疏松性股骨颈骨折断裂力学影响的有限元分析[J].中国组织工程研究,2019,23(12):1887-1892.
[5] 张成宝,余润泽,喻德富,等.有限元分析股骨颈骨折伴下后方不同程度骨缺损空心螺钉内固定后的稳定性[J].中国组织工程研究,2020,24(18):2799-2804.
[6] EBERLE S,GERBER C,VON OLDENBURG G,et al.A biomechanical evaluation of orthopaedic implants for hip fractures by finite element analysis and in-vitro tests[J].Journal of Engineering in Medicine,2010,224(10):1141-1152.
[7] 冯治国.步行训练机器人虚拟样机协同仿真方法研究[J].贵州大学学报(自然科学版),2013,30(1):55-58.
[8] 李海波,许圣茜,汤雪霞,等.术前牵引对股骨颈骨折术后发生股骨头缺血性坏死的影响研究[J].中国修复重建外科杂志,2019,33(6):671-675.
[9] 魏志辉,张铭华,张中卒,等.髋部骨折术前皮肤牵引治疗的系统评价[J].中国组织工程研究,2019,23(16):2594-2600.
[10] 刘大海,李海波,苟永胜,等.不同体位及牵引质量对股骨颈骨折后髋关节囊内压的影响[J].中国组织工程研究,2019,23(36):5846-5849.
[11] ESTRADA-MASLLORENS J M,CABRERA-JAIME S.Randomised clinical trial on pain control in intertrochanteric fractures of the femur with and without skin traction[J].Enferm Clin,2011,21(5):264-270.
[12] EVEN J L,RICHARDS J E,CROSBY C G,et al.Preoperative skeletal versus cutaneous traction for femoral shaft fractures treated within 24 hours[J].J Orthop Trauma,2012,26(10):e177-e182.
[13] PARKER M J,HANDOLL H H G.Pre-operative traction for fractures of the proximal femur in adults[J].Cochrane Database Syst Rev,2006,19(3):CD00J168.

更新日期/Last Update: 2021-02-15