采用数字人模型探究DDH闭合复位后股骨头缺血坏死的发生机制

发布时间：2018-04-25 01:04

本文选题：数字人模型 + 有限元分析　；参考：《中国矫形外科杂志》2017年19期

【摘要】：[目的]利用数字人三维模型结合有限元技术,对髋关节内部生物力学情况进行分析,探究髋关节发育不良(DDH)闭合复位后发生股骨头缺血坏死(AVN)的可能机制。[方法]基于中国女婴1号数字人数据集,重建中国女婴髋关节三维模型,模拟髋关节屈曲外展运动过程,通过三维有限元技术观察髋臼和股骨头之间挤压力的大小和其空间位置改变情况。[结果]该三维模型清晰的反映了髋关节内部组成和空间结构;有限元模型从髋关节伸直位至屈髋90°外展60°过程中,髋臼侧所受挤压点呈现自髋臼中心处向髋臼前下方再向髋臼下方"U"形软骨凹的空间转移过程,股骨头表面所受挤压点呈现出从上到下再到上,从集中到分散再到集中的空间变化过程;股骨头表面压力峰值在屈髋90°、外展50°后进入更高的压力范围。[结论]中国女婴1号数字人髋关节三维模型具有代表性,有助于了解新生儿髋关节的内部结构;DDH闭合复位后AVN的发生机制可能与该屈髋外展位下头臼间的接触挤压压迫了通过该点的股骨头供血血管有关,其与股骨头表面升高的挤压力,共同导致了股骨头缺血坏死的发生。
[Abstract]:[objective] to investigate the possible mechanism of avascular necrosis of femoral head (AVN) after closed reduction of dysplasia of hip (DDH) by using digital human three-dimensional model and finite element technique. [methods] based on the Chinese female baby 1 digital human data set, the hip joint 3D model of Chinese female infant was reconstructed to simulate the flexion and outreaching motion of the hip joint. The extrusion force between acetabular and femoral head and its spatial position were observed by three dimensional finite element technique. [results] the three-dimensional model clearly reflected the internal composition and spatial structure of the hip joint, and the finite element model was used in the process from the extension of the hip joint to the extension of the hip joint to the extension of the flexion hip to the 90 掳abduction of the hip joint. The compression point of the acetabular side showed a spatial transfer process from the acetabular center to the anterior acetabular and then to the "U" concave below the acetabular, and the compression point on the surface of the femoral head appeared from top to bottom to top. The peak value of the surface pressure of the femoral head was 90 掳in the flexion hip and 50 掳in the abduction, and entered a higher pressure range. [conclusion] the 3D model of Chinese female baby No. 1 digital human hip joint is representative. It may be helpful to understand the mechanism of AVN after closed reduction of the internal structure of the hip joint of the newborn, which may be related to the compression of the blood supply vessels of the femoral head through the contact between the head and the acetabulum under the external extension of the flexion hip. Combined with the increased extrusion pressure on the surface of the femoral head, the avascular necrosis of the femoral head occurred.
【作者单位】：上海交通大学医学院附属新华医院儿童骨科;上海市第一人民医院分院;南方医科大学基础医学院解剖教研室;
【分类号】：R726.8

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