肌肉负荷对股骨干骨折早期愈合生物力学影响的有限元分析

Finite element analysis of muscle loading effect on biomechanics of early healing of femoral stem fractures

背景:以往的研究多通过忽略肌肉负荷和采用简化股骨负荷的方式,进行骨折早期愈合的生物力学分析。然而,肌肉负荷对骨折早期愈合产生的生物力学影响尚不清楚。目的:构建不同的股骨负荷模型,研究肌肉负荷对骨折愈合的生物力学影响,帮助临床医生更好地理解骨折愈合的生物力学过程,优化治疗方案。方法:利用AnyBody Modeling System软件构建个性化的人体肌肉骨骼系统,通过仿真分析以获取体内的肌肉骨骼负荷模型。该模型和采用改进简化负荷方法、简化负荷方法构建的股骨负荷模型,分别作为有限元输入的边界条件,对站立状态下锁定加压钢板应力应变、骨折块应变进行分析。结果与结论:(1)与简化负荷方法相比,肌肉骨骼方法得到的锁定加压钢板应力、应变和骨折块应变分别小了31.9%;38.9%和19.5%;(2)肌肉骨骼方法与改进简化负荷方法对比发现,忽略肌肉负荷则会造成锁定加压钢板的应力、应变和骨折块应变分别高估16.8%,14.3%和19.5%,肌肉负荷对骨折块的剪切运动大小无明显影响,而对运动方向有明显的影响;(3)结果表明,简化股骨负荷和忽略肌肉负荷的方法与肌骨骨骼负荷情况存在一定的偏差,因此,在研究骨折愈合时需考虑肌肉负荷的生物力学影响。

BACKGROUND:Previous studies have mostly performed biomechanical analysis of early fracture healing by ignoring muscle loading and using simplified femoral loading.Nevertheless,the biomechanical effects of muscle loading on early fracture healing are still uncertain.OBJECTIVE:To construct various femoral loading models allows for the study of the biomechanical effects of muscle loading on fracture healing,enabling clinicians to gain a deeper understanding of the biomechanical process of fracture healing and to optimize treatment protocols.METHODS:The AnyBody Modeling System software was employed to construct a personalized human musculoskeletal system,which was then analyzed by simulation in order to obtain the musculoskeletal loading model in vivo.This model,along with the femur loading model constructed using the improved simplified loading method and the simplified loading method,was utilized as boundary conditions for the finite element inputs,which were used to analyze the locking compression plate stress-strain and interfragmentary strain in the standing condition,respectively.RESULTS AND CONCLUSION:(1)The locking compression plate stresses and strains and interfragmentary strains obtained from the musculoskeletal method were,respectively,31.9%,38.9%,and 19.5%smaller than those obtained from the simplified loading method.(2)A comparison of the musculoskeletal method with the modified simplified loading method revealed that the neglect of muscle loading resulted in an overestimation of locking compression plate stress and strain,as well as interfragmentary strain,by 16.8%,14.3%,and 19.5%,respectively.Muscle loading did not have a significant effect on the magnitude of the shear motion of the fracture block,whereas it did have a significant effect on the direction of motion.(3)The results indicated that the simplified femoral loading and the method of ignoring muscle loading exhibited some deviation from the musculoskeletal loading situation.Consequently,it is necessary to consider the biomechanical effects of muscle loading in the study of fracture healing.