股骨转子部骨折六部分骨折分型产生机制的有限元分析

发布时间：2018-07-31 05:22

【摘要】：目的:建立股骨上段三维有限元模型,探讨股骨转子部六部分分型的产生机制,并对不同分型的手术方式给出建议。方法:应用64层螺旋CT对1例60岁正常男性志愿者左侧股骨近段进行扫描,所得图像以.jpg格式保存,并导入Photoshop 7.0软件进行三维模型绘制,将所得三维图像运用Super 93软件建立股骨近段三维有限元模型,划分节点764个,单元531个(密质骨306个、松质骨225个)。运用该模型模拟人摔倒过程中髋关节内收、外展、内收内旋、外展外旋及髋关节内收内旋同时臀中肌、梨状肌、髂腰肌剧烈收缩状况下转子间的应力分布情况。结果:单纯髋关节内收时,应力主要分布于外侧骨皮质部并向转子间区扩散(二部分骨折)。单纯髋关节外展时,应力主要分布于内侧骨皮质部并向转子间区扩散(二部分骨折)。髋关节内收内旋或外展外旋时,应力均在大转子及转子部的前侧壁及后侧壁较为集中,并同时向内、外侧骨皮质及转子间区扩散(三、四部分骨折)髋关节内收内旋同时梨状肌、臀中肌、髂腰肌剧烈收缩时,应力在大转子、小转子及转子部的前侧壁及后侧壁较为集中,并同时向内、外侧骨皮质及转子间区扩散(五、六部分骨折)。结论:股骨转子间六部分分型符合人摔倒时转子部所受的复杂应力情况,结合CT三维重建,较以往的分型更加直观,并对不同分型的手术方式给出建议。
[Abstract]:Objective: to establish a three dimensional finite element model of the upper femur, to explore the mechanism of the six parts of the femoral trochanter, and to give some suggestions for different types of operation. Methods: the proximal left femur of a 60-year-old male volunteer was scanned with 64-slice spiral CT. The images were saved in jpg format, and the 3D model was constructed with Photoshop 7.0 software. Three-dimensional finite element model of proximal femur was established by using Super 93 software. The 3D images were divided into 764 nodes and 531 units (306 dense bones and 225 cancellous bones). The model was used to simulate the stress distribution of hip joint adductor, abductor, adductor, abductor and hip adductor, piriformis and iliopsoas muscles during fall. Results: the stress was mainly distributed in the lateral cortex and spread to the intertrochanteric region when the hip was adducted. The stress was mainly distributed in the medial cortex and spread to the intertrochanteric region (two parts of fracture). In the adductive rotation or outreaching of the hip joint, the stress was concentrated in the anterior and posterior walls of the greater trochanter and the trochanter, and diffused simultaneously to the medial, lateral cortex and intertrochanteric region. The stress was concentrated in the anterior and posterior walls of the greater trochanter, the small trochanter and the trochanter when the adductor and piriformis muscles, gluteus medius muscle and iliopsoas muscle of the hip joint contracted violently. Diffusion of lateral cortex and intertrochanteric area (5, 6 parts of fracture). Conclusion: the classification of six parts of femoral trochanter accords with the complex stress of the trochanter when the human falls. Combined with CT 3D reconstruction, the classification is more intuitive than the previous classification, and some suggestions for different types of operation are given.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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