北京生物醫(yī)學(xué)工程

彈性髓內(nèi)釘治療兒童股骨干長螺旋形骨折的生物力學(xué)分析

Biomechanical analysis of elastic intramedullary nail in the treatment of long spiral fracture of femoral shaft in children

作者：張娜路露萬永建

單位：華北醫(yī)療健康集團(tuán)峰峰總醫(yī)院骨五科(河北邯鄲 056200)<br />通信作者：張娜。E-mail：[email protected]

關(guān)鍵詞：有限元分析；髓內(nèi)釘；股骨干；長螺旋形骨折；生物力學(xué)

分類號：R318.04 

出版年·卷·期（頁碼）：2022·41·5（506-509）

摘要：

目的運(yùn)用有限元分析方法對彈性髓內(nèi)釘治療兒童股骨干長螺旋形骨折進(jìn)行生物力學(xué)分析，為臨床手術(shù)方式提供參考依據(jù)。方法構(gòu)建兒童股骨干長螺旋形骨折和髓內(nèi)釘有限元模型，采用骨折頂點(diǎn)置釘和對稱置釘兩種方式進(jìn)行負(fù)重、旋轉(zhuǎn)和四點(diǎn)彎曲實(shí)驗(yàn)，計(jì)算股骨應(yīng)力分布和應(yīng)力峰值等。結(jié)果在模擬負(fù)重位狀態(tài)下，兩組的應(yīng)力峰值均在髓內(nèi)釘和骨的接觸處，且A組的應(yīng)力峰值明顯低于B組應(yīng)力峰值。A組在抗內(nèi)翻、壓縮和抗反屈的表現(xiàn)上優(yōu)于B組，并且抗股骨旋轉(zhuǎn)能力增強(qiáng)，內(nèi)旋和外旋剛度分別提高171%和85%。結(jié)論治療兒童股骨長螺旋形骨折采用骨折頂點(diǎn)置釘相比于對稱置釘?shù)目狗辞⒖箖?nèi)翻、抗壓縮和抗旋轉(zhuǎn)的性能更高。

Objective To analyze the biomechanics of elastic intramedullary nail in the treatment of long spiral fracture of femoral shaft in children by finite element method, and to provide reference for clinical operation. Methods The finite element models of long spiral fracture and intramedullary nail of femoral shaft in children were constructed. The load-bearing, rotation and four-point bending experiments were carried out by two methods of nail placement at the fracture apex and symmetrical nail placement, and the stress distribution and stress peak of femur were calculated. Results In the simulated load-bearing position, the stress peak of both groups was at the contact of intramedullary nail and bone, and the stress peak of group A was significantly lower than that of group B. Group A was superior to group B in the performance of anti varus, compression and anti flexion, and the anti rotation ability of femur was enhanced. The stiffness of internal rotation and external rotation were increased by 171% and 85%, respectively. Conclusions Compared with the symmetrical nail placement, the nail placement at the apex of the fracture has higher anti flexion, anti varus, anti compression and anti rotation performance in the treatment of children's long spiral fracture of femur.

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