基于有限元方法的Vancouver B2型假体周围骨折治疗方法的比较

Comparison of different treatment methods for Vancouver type B2 fracture based on finite element analysis

目的:用有限元分析方法对Vancouver B2型假体周围骨折不同治疗方法进行比较。方法:采集30位中老年健康志愿者左侧股骨数据,并采集M/L Taper假体,Wagner SL假体及锁定板外形数据。将所采集的数据导入有限元分析软件进行建模,模拟Vancouver B2型假体周围骨折的不同治疗方式。模拟不同负重情况下的载荷,采集各种治疗方式在不同载荷下的骨折端位移并进行统计学分析。结果:在不同载荷作用下,各组骨折端位移有统计学差异(P<0.05)。经两两比较可知,第1种治疗方式与后3种治疗方式间骨折端位移有统计学差异(P<0.05);后3种治疗方式下,骨折端位移无统计学差异(P>0.05)。结论:Wagner SL翻修假体可以用于Vancouver B2型假体周围骨折的治疗。在选择假体长度时,应尽量选择骨折线远端匹配长度大于股骨直径2倍的假体,若因其他原因无法使用理想长度的假体,则可在应用较短假体的基础上,配合使用锁定板内固定。

Objective：To compare different treatment methods for Vancouver type B2 fracture based on finite element analysis.Methods：The data of left femurs of 30 healthy aged volunteers,M/L Taper prosthesis and Wagner S/L prosthesis were collected.The data were inputted into finite element analysis software and Vancouver type B2 fracture was simulated. The offsets of fractures under different loads were recorded and analysed by statistic software. Results：Under both load conditions,significant statistical difference could be found among the four groups（P〈0.05）. With pair-wised comparisons,significant statistical differences could be found between the first group and the rest 3 groups（P〈0.05）,but no statistical difference could be found among the last 3 groups.Conclusion：Wagner SL prosthesis could be used for the treatment of Vancouver type B2 fractures. The optimum length of the distal fixed part should be twice longer than the diameter of the femur. If the prosthsis with ideal length could not be used,a shorter prosthesis could be considered,but a combination of locking compressed plate is recommended.