【摘要】 目的采用三维有限元方法分析新型钉棒系统在股骨颈骨折模型中的固定效果。方法选择1位27岁健康男性志愿者,既往体格健壮,X线检查未见髋关节发育异常,行髋关节CT扫描,收集其股骨中上段影像学数据,应用SimpleWare 2.0软件建立正常人股骨中上段的三维有限元模型,利用ScanIP软件将该模型生成为PauwelsⅡ型股骨颈骨折三维有限元模型。建立新型钉棒系统和传统3枚空心螺纹钉的三维模型,分别装配至PauwelsⅡ型股骨颈骨折模型,生成装配后的模型两组,即传统3枚空心螺纹钉固定模型和新型钉棒系统固定模型。应用Abaqus 6.10软件,分别于两组股骨颈骨折三维有限元模型中进行模拟轴向应力加载,于股骨头上缘的负重区域采点,每个三维有限元模型在该区域范围内均匀采点20个,记录每个位点的轴向位移值。结果传统3枚空心螺纹钉固定模型股骨头负重区的平均轴向位移值为(0.540±0.038)mm,显著大于新型钉棒系统固定模型的(0.487±0.046)mm(P<0.05)。结论新型钉棒系统用于PauwelsⅡ型股骨颈骨折治疗,与传统3枚空心螺纹钉固定相比,其在轴向抗位移中具有更佳的固定强度,可有效减少术后骨折端轴向位移。更多还原

【Abstract】 Objective To analyze the fixation effect of the new nail rod system in femoral neck fracture model by three-dimensional finite element analysis.Methods A healthy 27-year-old male volunteer in good physical condition was selected,and no dysplasia of the hip joint was found on X-ray examination.Imaging information of upper middle section of the femur was collected by CT scanning.Three-dimensional finite element model of normal upper middle section of the femur was established by the SimpleWare 2.0 software.Then the model was transformed into Pauwels type Ⅱfemoral neck fracture model using ScanIP software.New nail stick system and traditional three hollow screw nails were assembled to the Pauwels type Ⅱ femoral neck fracture model,respectively.Axial stress loading was simulated in the two three-dimensional finite element models of femoral neck fractures using Abaqus 6.10 software.In each three-dimensional finite element model,20 points were collected uniformly in the load-bearing region at the upper margin of the femoral head,and the displacement of each unit was recorded.Results The average axial displacement of the load-bearing area of femoral head in the traditional 3 screw fixation models was(0.540±0.038)mm,which was significantly higher than that of the model fixated by the screw-rod system([0.487±0.046]mm,P<0.05).Conclusion Compared with traditional screw fixation,screw-rod fixation can result in better stability in Pauwels type Ⅱ femoral neck fracture and effectively reduce postoperative axial displacement of the fracture.(Shanghai Med J,2018,41:672-675)更多还原