基于有限元法的Vancouver B1型股骨假体周围骨折内固定力学分析

发布时间：2018-01-25 14:20

本文关键词： 有限元分析股骨骨折假体周围骨折 Vancouver B型内固定　出处：《第二军医大学学报》2017年02期 　论文类型：期刊论文

【摘要】：目的基于有限元方法,对Vancouver B1型股骨假体周围骨折内固定后的稳定性及生物力学状态进行分析研究。方法收集30名中老年健康志愿者左侧股骨CT图像数据以及股骨假体、锁定钛板的外形数据并进行三维重建。模拟人工髋关节置换术后假体周围骨折锁定板内固定手术,近端分别采用钛缆捆扎、锁定螺钉单层皮质固定及两者组合,施加模拟完全负重及部分负重的载荷,观察最大位移及峰值应力情况。结果对于近端钛缆捆扎与锁定螺钉单层皮质固定两种方式,在模拟完全负重及部分负重压力载荷作用下的骨折位移,锁定板、假体及股骨上的应力峰值差异均无统计学意义,也即钛缆捆扎和锁定螺钉单层皮质固定后生物力学状态无明显区别。但若将两者组合使用,则可增加内固定稳定性,并且降低锁定板应力峰值,与单独使用两种内固定方式的结果差异均有统计学意义(P0.05或P0.01)。结论对于Vancouver B1型股骨假体周围骨折切开复位锁定板内固定手术,钛缆捆扎结合锁定螺钉单层皮质固定是首选的内固定方式。
[Abstract]:The purpose is based on finite element method. Vancouver. The stability and biomechanical status of femoral periprosthetic fracture were analyzed and studied after internal fixation. Methods CT images of left femur and femoral prosthesis were collected from 30 middle-aged and aged healthy volunteers. The shape data of titanium plate were locked and reconstructed. After artificial hip arthroplasty, the locking plate fixation of periprosthetic fracture was performed, and the proximal end was tied with titanium cable, single layer cortical fixation with locking screw and a combination of the two. The maximum displacement and peak stress were observed. Results for the proximal titanium cable binding and locking screw monolayer fixation. There was no significant difference in fracture displacement, locking plate, prosthesis and femur stress peak under simulated full load and partial load. There was no significant difference in biomechanical state between titanium cable binding and locking screw fixation, but if the two were combined, the stability of internal fixation could be increased and the peak stress of locking plate could be reduced. There were significant differences between the two internal fixation methods (P0.05 or P0.01). Conclusion for Vancouver B1 type periprosthetic fracture of femur, open reduction and locking plate fixation were performed. Titanium cable binding combined with locking screw monolayer fixation is the preferred internal fixation method.
【作者单位】：中国石油天然气集团公司中心医院骨科;中国石油天然气集团公司中心医院介入科;
【分类号】：R687.3;R318.01
【正文快照】： [Acad J Sec Mil Med Univ,2017,38(2):253-257]股骨假体周围骨折是人工髋关节置换术后的严重并发症之一,其发生率约0.1%~6%[1-4]。其中以Vancouver B1型骨折最为常见,约占股骨假体周围骨折总数的75%,其保守治疗的骨折不愈合发生率约为42%[1,5-6]。Vancouver B1型骨折的常见手

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