摘要
目的探讨普通股骨近端防旋髓内钉和骨水泥增强股骨近端防旋髓内钉治疗高龄不稳定型股骨转子间骨折的生物力学差异。方法选取1名志愿者CT资料导入Mimics 19.0和Geomagic studio 2017软件中进行提取、优化得到右侧股骨三维模型;运用Solidworks 2017软件画出内固定模型并与股骨模型按照标准手术技术装配,以step格式导入Hypermesh14.0软件中截骨得到EvansⅤ型股骨转子间骨折模型,截取螺旋刀片近端周围部分松质骨重新定义为骨水泥部件,分别存为A模型(普通股骨近端防旋髓内钉)和B模型(骨水泥增强股骨近端防旋髓内钉),设置材料参数、边界条件、施加载荷,分别储存为K文件导入LS-DYNA软件进行分析,观察螺旋刀片切割程度、股骨颈内翻变化、股骨颈旋转程度、股骨近端应力分布和股骨近端位移。结果骨水泥增强股骨近端防旋髓内钉模型的螺旋刀片切割程度较轻,股骨头颈骨块内翻和旋转角度、骨折端应力和位移均较小。结论骨水泥增强股骨近端防旋髓内钉治疗高龄EvansⅤ型股骨转子间骨折较普通股骨近端防旋髓内钉具有更好的生物力学效果。
ObjectiveTo explore the biomechanical difference between the treatment of unstable femoralintertrochanteric fractures with common proximal femoral anti rotation nail and bone cement augmented proximal femoralanti rotation nail.MethodsA healthy volunteer was selected to import the CT data into the software of Mimics 19.0 andGeomagic studio 2017 to extract and optimize the three-dimensional model of the right femur.The Solid works 2017 softwarewas used to draw the internal fixation model and assemble it with the femur model according to the standard operationtechnology,and import it into Hypermesh 14.0 software in step format to cut the bone according to Evans V type ofintertrochanteric fracture.The part of the cancellous bone on the surface of the proximal spiral blade was redefined as thebone cement component,which was stored as A and B models respectively.The material parameters,boundary conditionsand applied loads were set,which were stored as K files and imported into LS-DYNA software for solution.The bladecutting,inversion and rotation of proximal femoral neck bone mass and Von Mises stress and displacement distribution wereobserved.ResultsIn the model of cement augmented proximal femoral anti rotation nail,the cutting degree of the screwblade was lighter,the osteotomy and rotation angle of the femoral head and neck block were less,and the displacement of thefracture end was less.ConclusionThe treatment of Evans V type intertrochanteric fracture with bone cement augmentedproximal femoral anti rotation nail in elderly has better biomechanical effect than that of the common proximal femoral antirotation nail.
作者
黄培镇
陈心敏
郑利钦
林梓凌
董航
蔡群斌
HUANG Pei-zhen;CHEN Xin-min;ZHENG Li-qin;LIN Zi-ling;DONG Hang;CAI Qun-bin(Department of Traumatic Orthopedics,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Lingnan Medical Research Center of Guangzhou University of Chinese Medicine,Guangzhou 510405,China;The First School of Clinical Medicine of Guangzhou University of Chinese Medicine)
出处
《天津医药》
CAS
北大核心
2020年第5期385-390,I0002,共7页
Tianjin Medical Journal
基金
国家自然科学基金面上项目(81673996)。
关键词
转子间骨折
股骨近端防旋髓内钉
骨水泥
有限元
intertrochanteric fractur
proximal femoral nail anti-rotation
bone cement
finite element
