[1]潘陈通,余荣耀,余盛,等.股骨头旋转角度对股骨近端生物力学影响的有限元分析[J].中国中医骨伤科杂志,2023,31(11):41-46.[doi:10.20085/j.cnki.issn1005-0205.231108]
 PAN Chentong,YU Rongyao,YU Sheng,et al.Finite Element Analysis of Influence of Femoral Head Rotation Angle on Biomechanics of Proximal Femur[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2023,31(11):41-46.[doi:10.20085/j.cnki.issn1005-0205.231108]
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股骨头旋转角度对股骨近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31卷
期数:
2023年11期
页码:
41-46
栏目:
临床研究
出版日期:
2023-11-15

文章信息/Info

Title:
Finite Element Analysis of Influence of Femoral Head Rotation Angle on Biomechanics of Proximal Femur
文章编号:
1005-0205(2023)11-0041-06
作者:
潘陈通1余荣耀2余盛2陈泽铭1施泽文1余霄1陈先军1石林1王诚浩1庞清江1△
1宁波市第二医院骨科(浙江 宁波,315000); 2宁波大学医学院
Author(s):
PAN Chentong1YU Rongyao2YU Sheng2CHEN Zeming1SHI Zewen1YU Xiao1CHEN Xianjun1SHI Lin1WANG Chenghao1PANG Qingjiang1△
1Department of Orthopedics,Ningbo No.2 Hospital,Ningbo 315000,Zhejiang China; 2School of Medicine,Ningbo University,Ningbo 315211,Zhejiang China.
关键词:
股骨颈骨折 有限元分析 股骨头旋转 生物力学影响
Keywords:
femoral neck fracture finite element analysis femoral head rotation biomechanical efficacy
分类号:
R683.42
DOI:
10.20085/j.cnki.issn1005-0205.231108
文献标志码:
A
摘要:
目的:运用有限元分析法分析股骨颈骨折内固定术后股骨头旋转角度对股骨颈骨折股骨近端生物力学的影响,及股骨颈骨折术后股骨头旋转所带来的继发疾病,为此类患者临床治疗提供生物力学依据及指导。方法:对1名健康老年女性进行双侧髋关节CT扫描,将CT扫描断层数据导入Siemens NX12.0软件进行几何建模,按照手术要求,3枚钛合金螺钉(一枚半螺纹,两枚全螺纹)倒三角布置。股骨头骨折复位且位于正常位置为M0,上旋15°为M1,上旋10°为M2,上旋5°为M3,下旋5°为M4,下旋10°为M5,下旋15°为M6,下旋20°为M7,下旋25°为M8,共9组内固定模型,通过Dassault Simulia Abaqus 2021软件对所有模型施加载荷及约束,观察不同旋转角度下的股骨颈骨折股骨近端生物力学特点。结果:所有股骨头不同程度的旋转都会引起股骨近端的生物力学改变,不同旋转角度模型主要的位移变形在股骨头上9.60~13.70 mm; 不同旋转角度模型股骨近端所受的应力主要集中于粗隆下侧区域,应力峰值分别为193.26,331.54,329.70,334.02,195.50,197.31,199.71,230.58,250.48 MPa; 不同旋转角度模型股骨头最大应力分别为91.81,66.90,42.24,57.83,84.86,78.79,68.86,56.22,36.64 MPa。结论:股骨头向下旋转10°以内应力变化较小,同时股骨头位移最小,股骨头空间旋转角度和股骨近端生物力学改变正相关,可为临床内固定治疗股骨颈骨折提供参考。
Abstract:
Objective:To analyze the impact of the rotation angle of the femoral head on the biomechanics of the hip joint of the femoral head and neck fracture and to provide biomechanical basis for secondary diseases,and provides biomechanical guidance for clinical treatment of such patients with the finite element analysis method.Methods:A healthy elderly woman was taken for bilateral hip CT scans,and the data were imported into Siemens NX12.0 software for geometric modeling.According to the surgical requirements,three titanium alloys(one half thread and two full threads)were arranged in an inverted triangle.The femoral head fracture reduced in the normal position as M0,15° of upper rotation is M1,10° of upper rotation is M2,5° of upper rotation is M3,15° of upper rotation is M1,10° of upper rotation is M2,5° of upper rotation is M3,5° of downward rotation is M4,10° of downward rotation is M5,15° of downward rotation M6,20° downward is M7,25° downward is M8.Loads and constraints were applied to all models by Dassault Simulia Abaqus 2021 software to observe the biomechanical characteristics of the proximal femoral segment of femoral neck fractures under different rotation angles.Results:Various degrees of rotation of femoral head causes biomechanical changes in the proximal femur.The main displacement and deformation in each rotation angle was on the femoral head(9.6013.70 mm).The stress on the proximal femur in each rotation angle was mainly concentrated in the lower side of the trochanter,the maximum Von Mises stress in each group was 193.26,331.54,329.70,334.02,195.50,197.31,199.71,230.58,250.48 MPa.The maximum stress of femoral head in each group was 91.81,66.90,42.24,57.83,84.86,78.79,68.86,56.22,36.64 MPa.Conclusion:The change of stress within 10° of downward rotation of the femoral head is slightly,and the displacement of the femoral head is minimal.The spatial rotation angle of the femoral head is positively correlated with the biomechanical changes of the proximal femur.This study provides some reference for clinical internal fixation treatment of femoral neck fractures.

参考文献/References:

[1] KANNUS P,PARKKARL J,SIEVANEN H,et al.Epidemiology of hip fractures[J].Bone,1996,18(1 Suppl):57S-63S.
[2] 藤立初.闭合复位空心螺纹钉内固定术治疗股骨颈骨折的研究进展[J].智慧健康,2018,4(16):37-38.
[3] 梁凡,彭昊,胡巍,等.股骨颈骨折术后继发股骨头坏死的危险因素分析[J].中华创伤杂志,2016,32(9):813-817.
[4] MIN B W,KIM S J.Avascular necrosis of the femoral head afterosteosynthesis of femoral neck fracture[J].Orthopedics,2011,34(5):e6-e11.
[5] 王添兴,李国庆,汪洋,等.股骨颈骨折闭合复位空心加压螺钉内固定术后股骨头坏死的影响因素分析[J].实用骨科杂志,2019,25(2):105-112.
[6] DU C L,MA X L,ZHANG T,et al.Reunderstanding of Garden type I femoral neck fractures by 3-dimensional reconstruction[J].Orthopedics,2013,36(6):820-825.
[7] 陈泽铭,杨放,庞清江.空心螺钉内固定治疗股骨颈骨折有限元分析的研究进展[J].现代实用医学,2021,33(5):698-700.
[8] BELLINI C M,GALBUSERA F,CERONI R G,et al.Loss in mechanical contact of cementless acetabular prostheses due to post-operative weight bearing:a biomechanical model[J].Medical Engineering & Physics,2007,29(2):175-181.
[9] 白详,李维学,高键,等.人体股骨头应力场分析[J].山东工学院学报,1983(2):9-16.
[10] KAHLENBERG C A,RICHARDSON S S,SCHAIRER W W,et al.Rates and risk factors of conversion hip arthroplasty after closed reduction percutaneous hip pinning for femoral neck fractures:a population analysis[J].The Journal of Arthroplasty,2018,33(3):771-776.
[11] KANE C,JO J,SIEGEL J,et al.Can we predict failure of percutaneous fixation of femoral neck fractures?[J].Injury,2020,51(2):357-360.
[12] SLOBOGEAN G P,SPRAGUE S A,SCOTT T,et al.Complications following young femoral neck fractures[J].Injury,2015,46(3):484-491.
[13] 刘冠虹,吉万波,刘锦涛,等.股骨颈骨折内固定术后股骨头坏死的相关因素分析及生活质量评价[J].中国骨伤,2020,33(8):750-757.
[14] 任立新,薛晓峰.髋关节置换术与骨折内固定术治疗老年股骨颈骨折89 例疗效对比分析[J].中国实用医刊,2017,44(2):96-98.
[15] 冯晓飞,余霄,庞清江.股骨颈骨折内固定术后股骨短缩的临床特点[J].中华骨与关节外科杂志,2018,11(5):364-369.

备注/Memo

备注/Memo:
基金项目:宁波市科技创新2025重大专项(2020Z096)
浙江省医药卫生科技项目(2022KY1129)
中国科学院大学宁波华美医院“华美研究基金”项目(2021HMKY09)
通信作者 E-mail:pangqingjiang@ucas.ac.cn
更新日期/Last Update: 2023-11-01