【摘要】 目的 通过有限元分析，比较交叉点改进前、后股骨近端仿生髓内钉(proximal femur bionic nail,PFBN)治疗股骨转子间骨折的生物力学特点。方法 选择1名年龄37岁、身高176 cm、体重70 kg的健康成年男性志愿者提供股骨全长CT扫描数据，通过Mimics 20.0软件、Geomagic Studio 13.0软件重建股骨实体化模型。利用UG NX 12.0软件建立EvansⅠ型股骨转子间骨折模型，重建PFBN模型(模型A)、增大锁定横钉与主钉成夹角PFBN模型(模型B)和水平上移锁定横钉PFBN模型(模型C)，并分别与骨折模型进行装配。在Abaqus 6.14软件中，模拟3倍体重载荷模式，获取三种内固定方式下股骨模型与内固定物最大应力分布、股骨整体位移和骨折断端间隙最大间隙位移数据。结果 在3倍体重载荷下，与模型A相比，模型B使斜钉最大应力减小11.91 MPa (12.9%)，但使斜钉与主钉通孔外侧壁最大应力增加12.54 MPa (7.7%)；而模型C使斜钉最大应力减小23.66 MPa (5.7%)，但使斜钉与主钉通孔外侧壁最大应力增加64.00 MPa (39.5%)。三种内固定方式下股骨整体位移和骨折断端间隙位移方面无明显改变。结论 与PFBN改进前相比，增大锁定横钉与主钉夹角的PFBN，既能够显著改善交叉点接触部位的应力分布，又不会使斜钉与主钉应力集中区域明显增加，有利于恢复股骨近端正常生物力学特性，减少内固定失败率及并发症。更多还原

【Abstract】 Objective To compare the biomechanical characteristics of modified proximal femoral bionic nail( PFBN) in the treatment of intertrochanteric fracture of femur by using the finite element analysis. Methods The femur full-length CT scan data provided by a healthy male volunteer aged 37 years, 176 cm in height and 70 kg in weight were selected, and the materialized femur model was reconstructed using Mimics 20.0 software and Geomagic Studio 13.0 software. The Evans Ⅰ intertrochanter fracture model was established by UG NX 12.0 software, and the PFBN model( model A) was reconstructed. The PFBN model( model B) was enlarged with the angle between the locking transverse nail and the main nail, and the horizontal upward locking transverse nail PFBN model( model C)was assembled with the fracture model respectively. In Abaqus 6.14, the loading mode of 3 times body weight was simulated to obtain the maximum stress distribution of the femur model and the internal fixator, the overall displacement of the femur, and the maximum gap displacement of the broken end of the fracture under three internal fixation methods. Results Compared with model A, the maximum stress of the skew nail decreased by 11.91 MPa( 12.9%) in model B, but the maximum stress of the outer side wall of the through-hole between the skew nail and the main nail increased by 12.54 MPa( 7.7%) under the load of 3 times the body weight. Model C can reduce the maximum stress of the skew nail by 23.66 MPa( 5.7%), but increase the maximum stress of the outer side wall of the through-hole between the skew nail and the main nail by 64.00 MPa( 39.5%). There was no significant change in the overall displacement of the femur and the displacement of the broken end space under three internal fixation methods.Conclusions Compared with the PFBN before improvement, increasing the angle between the locking transverse nail and the main nail can not only significantly improve the stress distribution at the contact site of the intersection, but also not significantly increase the stress concentration area between the oblique nail and the main nail, which is conducive to the restoring of the normal biomechanical characteristics of the proximal femur and reduction of the internal fixation failure rate and complications.更多还原