骨质疏松患者股骨头不同区域骨结构与生物力学分析

发布时间：2018-07-05 04:50

本文选题：骨质疏松 + 股骨头　；参考：《医用生物力学》2017年01期

【摘要】：目的探讨老年股骨颈骨折病人的股骨头样本各个区域的结构和生物力学性能差异,研究不同区域显微结构和生物力学特征及其对内固定物的影响。方法收集20个老年股骨颈骨折病人关节置换术后股骨头标本,以股骨头表面解剖标志点为参照,将股骨头按平分方法分为外侧、内侧、中间三部分。确定环钻的位置和钻取方向,用环钻于不同区域钻取直径10 mm、高10 mm圆柱形松质骨柱。通过Micro-CT系统扫描分析,分析不同区域内松质骨柱数据,包括骨体积分数(BVF)、骨小梁间隙(Tb.Sp)、骨小梁厚度(Tb.Th)、骨小梁数目(Tb.N)、骨表面积体积比(BS/BV)、结构模型指数(SMI)。应用微有限元计算不同区域骨组织的力学差异。结果老年股骨头颈内骨质含量下降,显微结构和生物力学性能区域变化明显,中间区域的骨结构和力学性能明显优于内侧和外侧。结论股骨头中间部位骨骼结构和力学强度明显优于内侧和外侧,在临床治疗骨质疏松股骨颈骨折的时候需要充分考虑内固定的部位。
[Abstract]:Objective to investigate the structure and biomechanical properties of femoral head samples from elderly patients with femoral neck fracture, and to study the microstructure and biomechanical characteristics of different regions and their effects on internal fixation. Methods the femoral head specimens were collected from 20 elderly patients with femoral neck fracture after joint replacement. The femoral head was divided into three parts: lateral, medial and middle according to the method of dividing the femoral head according to the anatomic points on the surface of the femoral head. The position and direction of the annular drill were determined. The diameter and height of the annular drill were 10 mm and 10 mm respectively. Micro-CT system was used to analyze the data of cancellous bone column in different areas, including bone volume fraction (BVF), trabecular space (TB. Sp), trabecular thickness (TB. Th), trabecular number (TB. N), bone surface area volume ratio (BS- BV) and structural model index (SMI). The mechanical differences of bone tissues in different regions were calculated by micro finite element method. Results the content of bone in the neck of the femoral head in the elderly decreased, the microstructure and biomechanical properties of the femoral head were changed obviously, and the bone structure and mechanical properties in the middle region were better than those in the medial and lateral areas. Conclusion the bone structure and mechanical strength in the middle part of the femoral head are superior to those in the medial and lateral areas. The internal fixation should be taken into account in the treatment of osteoporotic femoral neck fractures.
【作者单位】：上海交通大学医学院附属同仁医院骨科;上海交通大学医学院附属第九人民医院骨科上海市骨科内植物重点实验室;
【分类号】：R580;R683;R318.01

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