青壮年股骨颈骨折伴后内壁骨缺损两种固定方式的三维有限元分析

发布时间：2018-05-15 06:49

  本文选题：青壮年 + 后内壁骨缺损　； 参考：《南华大学》2015年硕士论文

【摘要】：目的:对青壮年股骨颈骨折伴后内壁骨缺损这种特殊类型的骨折行三枚空心螺钉与DHS加防旋螺钉固定的稳定性进行三维有限元分析并进行比较研究,以期为这一特殊类型股骨颈骨折内固定方式的临床应用提供理论依据。方法:选取一名男性健康青壮年中国公民,44岁,体重75kg,要求双侧股骨、髋关节正常,无外伤史,对CT影像资料用途知情并同意。予以双侧股骨全长正、侧位、骨盆正位透视排除股骨、髋关节疾患后,通过双侧股骨CT薄层扫描获取相关数据,运用Geo Magic11.0、Mimics10.0和Ansys14.0等软件,建立左侧伴后内壁骨缺损股骨颈骨折的三维有限元模型。依据两种固定系统内植物的相关扫描数据,建立对应的三维有限元模型,分别将其导入左侧伴后内壁骨缺损的股骨颈骨折模型。设定边界和载荷条件,通过对人行走正常步态三种工况进行分析,得到股骨、内植物、骨折断面不同部位的位移值、位移分布和应力值、应力分布,分析三枚空心螺钉与DHS加防旋螺钉固定的稳定性。结果:建立青壮年伴后内壁5mm骨缺损的股骨颈骨折分别行三枚空心螺钉和DHS加防旋螺钉固定的三维有限元模型,模拟人行走正常步态三种工况下对股骨近端进行加载,DHS组较空心钉组内固定传导更多的应力,而DHS组较空心钉组的股骨颈传导更小的应力,DHS组较空心钉组股骨头的整体位移值减小;DHS组较空心钉组内植物的整体位移值减小;DHS组在骨折断面不同部位裂隙距离位移值较空心钉组减小,DHS组与空心;钉组在骨折断面不同部位裂隙距离位移值存在显著性差异,P0.05,具有统计学意义。结论:对青壮年伴后内壁骨缺损经颈型股骨颈骨折(PauwelsⅢ型),DHS加防旋螺钉固定的骨折面应力与裂隙距离、内植物总位移值、股骨整体位移值均小于三枚空心螺钉,具有生物力学优势。
[Abstract]:Objective: to analyze and compare the stability of three hollow screws and DHS screw fixation in the fracture of femoral neck with posterior inner wall bone defect in young adults. In order to provide theoretical basis for the clinical application of this special type of femoral neck fracture internal fixation. Methods: a male healthy young Chinese citizen, aged 44 years, weighing 75 kg, required bilateral femur, hip joint normal, no history of trauma, and informed and agreed to the use of CT imaging materials. The total length of femur, lateral position and pelvic position were excluded from femoral and hip joint diseases. The relevant data were obtained by thin slice CT scanning of bilateral femur, and the software of Geo Magic11.0 Mimics10.0 and Ansys14.0 were used. A three-dimensional finite element model of femoral neck fracture with left internal bone defect was established. According to the relative scanning data of the plants in the two fixation systems, the corresponding three-dimensional finite element model was established and introduced into the left femoral neck fracture model with posterior wall bone defect respectively. By setting the boundary and loading conditions, the displacement, displacement distribution, stress distribution and stress distribution of different parts of femur, internal plant and fracture section were obtained by analyzing the normal gait of human walking. The stability of three hollow screws and DHS with anti-screw fixation was analyzed. Results: three dimensional finite element models of femoral neck fracture with posterior wall 5mm bone defect and three hollow screws and DHS screw fixation were established. The loading of proximal femur in DHS group was more stress conduction than that in hollow nail group under three working conditions of simulated human walking normal gait. The stress of femoral neck conduction in DHS group is smaller than that in hollow nail group. The global displacement of femoral head in DHS group is smaller than that in hollow nail group, and the fracture distance in different parts of fracture section in DHS group is smaller than that in hollow nail group. The displacement value was lower in DHS group and hollow group than in hollow nail group. There was significant difference in the displacement of fracture distance between nail group and fracture section (P 0.05). Conclusion: the fracture surface stress and fracture distance, the total displacement of the implants, the total displacement of the femur and the total displacement of the femur were less than three hollow screws in the young adults with posterior internal wall bone defect and Pauwels type 鈪，

本文编号：1891424