北京生物医学工程

弹性髓内钉治疗儿童股骨干长螺旋形骨折的生物力学分析

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

作者：张娜路露万永建

单位：华北医疗健康集团峰峰总医院骨五科(河北邯郸 056200)<br />通信作者：张娜。E-mail：83392075@qq.com

关键词：有限元分析；髓内钉；股骨干；长螺旋形骨折；生物力学

分类号：R318.04 

出版年·卷·期（页码）：2022·41·5（506-509）

摘要：

目的运用有限元分析方法对弹性髓内钉治疗儿童股骨干长螺旋形骨折进行生物力学分析，为临床手术方式提供参考依据。方法构建儿童股骨干长螺旋形骨折和髓内钉有限元模型，采用骨折顶点置钉和对称置钉两种方式进行负重、旋转和四点弯曲实验，计算股骨应力分布和应力峰值等。结果在模拟负重位状态下，两组的应力峰值均在髓内钉和骨的接触处，且A组的应力峰值明显低于B组应力峰值。A组在抗内翻、压缩和抗反屈的表现上优于B组，并且抗股骨旋转能力增强，内旋和外旋刚度分别提高171%和85%。结论治疗儿童股骨长螺旋形骨折采用骨折顶点置钉相比于对称置钉的抗反屈、抗内翻、抗压缩和抗旋转的性能更高。

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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