天津医药

天津医药 ›› 2020, Vol. 48 ›› Issue (5): 385-390.doi: 10.11958/20193661

• 临床研究 • 上一篇    下一篇

骨水泥增强股骨近端防旋髓内钉治疗高龄不稳定型股骨转子间骨折的有限元分析 #br#

黄培镇 1，陈心敏 2，郑利钦 2，林梓凌 1△，董航 1，蔡群斌 1
  

  1. 1广州中医药大学第一附属医院创伤骨科，广州中医药大学岭南医学研究中心（邮编 510405）；2 广州中医药大学第一临床医
    学院

  • 收稿日期:2019-12-05 修回日期:2020-01-23 出版日期:2020-05-15 发布日期:2020-06-24
  • 通讯作者: 林梓凌 E-mail:13600460045@126.com
  • 基金资助:
    国家自然科学基金面上项目（81673996）

Finite element analysis of the treatment of unstable femoral intertrochanteric fractures with#br# bone cement augmented proximal femoral anti rotation nail in elderly #br#

HUANG Pei-zhen1, CHEN Xin-min2, ZHENG Li-qin2, LIN Zi-ling1△, DONG Hang1, CAI Qun-bin1 #br#   

  1. 1 Department of Traumatic Orthopedics, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Lingnan
    Medical Research Center of Guangzhou University of Chinese Medicine, Guangzhou 510405, China;
    2 The First School of Clinical Medicine of Guangzhou University of Chinese Medicine
  • Received:2019-12-05 Revised:2020-01-23 Published:2020-05-15 Online:2020-06-24

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摘要： 摘要：目的 探讨普通股骨近端防旋髓内钉和骨水泥增强股骨近端防旋髓内钉治疗高龄不稳定型股骨转子间
骨折的生物力学差异。方法 选取 1名志愿者 CT资料导入 Mimics 19.0和 Geomagic studio 2017软件中进行提取、优
化得到右侧股骨三维模型；运用 Solidworks 2017软件画出内固定模型并与股骨模型按照标准手术技术装配，以 step
格式导入 Hypermesh14.0软件中截骨得到 Evans Ⅴ型股骨转子间骨折模型，截取螺旋刀片近端周围部分松质骨重新
定义为骨水泥部件，分别存为 A模型（普通股骨近端防旋髓内钉）和 B模型（骨水泥增强股骨近端防旋髓内钉），设置
材料参数、边界条件、施加载荷，分别储存为 K文件导入 LS-DYNA软件进行分析，观察螺旋刀片切割程度、股骨颈内
翻变化、股骨颈旋转程度、股骨近端应力分布和股骨近端位移。结果 骨水泥增强股骨近端防旋髓内钉模型的螺旋
刀片切割程度较轻，股骨头颈骨块内翻和旋转角度、骨折端应力和位移均较小。结论 骨水泥增强股骨近端防旋髓
内钉治疗高龄 Evans Ⅴ型股骨转子间骨折较普通股骨近端防旋髓内钉具有更好的生物力学效果。

关键词: 转子间骨折, 股骨近端防旋髓内钉, 骨水泥, 有限元

Abstract: Abstract： Objective To explore the biomechanical difference between the treatment of unstable femoral
intertrochanteric fractures with common proximal femoral anti rotation nail and bone cement augmented proximal femoral
anti rotation nail. Methods A healthy volunteer was selected to import the CT data into the software of Mimics 19.0 and
Geomagic studio 2017 to extract and optimize the three-dimensional model of the right femur. The Solid works 2017 software
was used to draw the internal fixation model and assemble it with the femur model according to the standard operation
technology, and import it into Hypermesh 14.0 software in step format to cut the bone according to Evans V type of
intertrochanteric fracture. The part of the cancellous bone on the surface of the proximal spiral blade was redefined as the
bone cement component, which was stored as A and B models respectively. The material parameters, boundary conditions
and applied loads were set, which were stored as K files and imported into LS-DYNA software for solution. The blade
cutting, inversion and rotation of proximal femoral neck bone mass and Von Mises stress and displacement distribution were
observed. Results In the model of cement augmented proximal femoral anti rotation nail, the cutting degree of the screw
blade was lighter, the osteotomy and rotation angle of the femoral head and neck block were less, and the displacement of the
fracture end was less. Conclusion The treatment of Evans V type intertrochanteric fracture with bone cement augmented
proximal femoral anti rotation nail in elderly has better biomechanical effect than that of the common proximal femoral anti
rotation nail.

Key words: intertrochanteric fractur, proximal femoral nail anti-rotation, bone cement, finite element

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