不同内固定方式治疗股骨干粉碎性(Winquist-Hansen Ⅲ级)骨折有限元分析

Finite Element Analysis of Different Internal Fixation Methods for Treatment of Comminuted Femoral Shaft Fracture(Winquist-Hansen Ⅲ)

目的探讨髓内钉联合锁定钢板、单纯髓内钉、双锁定钢板及髓内钉联合钢丝治疗股骨干粉碎性骨折(Winquist-HansenⅢ级)的生物力学性能,以选择最佳的内固定方式,从而有效刺激骨痂形成,促进骨折愈合,缩短骨折愈合时间。方法应用有限元分析方法,对股骨干粉碎性骨折(Winquist-Hansen Ⅲ级)模型施加700 N轴向载荷,比较4种不同内固定方式下的股骨整体应力及位移。结果有限元分析结果表明:髓内钉联合锁定钢板内固定方式的股骨整体应力低于单纯髓内钉及髓内钉联合钢丝,高于双锁定钢板;在施加700 N轴向载荷下,髓内钉联合锁定钢板内固定方式的股骨整体位移为0~1.13 mm,单纯髓内钉位移为0~2.31 mm,双锁定钢板位移为0~0.67 mm,髓内钉联合钢丝位移为0~2.02 mm。结论髓内钉联合锁定钢板治疗股骨干骨折应力更适中,双锁定钢板稳定性最好,髓内钉联合锁定钢板能产生更合适应力刺激骨痂生长,进而促进骨折愈合。

Objective To explore the biomechanical properties of intramedullary nail combined locking steel plate,simple intramedullary nail,double locking steel plate and intramedullary nail combined with steel wire for the treatment of crushed femoral shaft fracture(Winquist-HansenⅢlevel),choose the best internal fixation method,so as to effectively stimulate bone scab formation,promote fracture healing and shorten fracture healing time.Method The finite element analysis method was applied to the femoral shaft comminuted fracture(Winquist-Hansen Ⅲ level)model with an axial load of 700 N to compare the overall stress and displacement of the femur under four different internal fixation methods.Results The results of finite element analysis show that the overall stress of the femur in the intramedullary nail joint locking steel plate is lower than that of the simple intramedullary nail and intramedullary nail joint steel wire,and higher than the double locking steel plate;at an axial load of 700 N,the overall displacement of the femur in the joint locking steel plate of the intramedullary nail is 0~1.13 mm,the displacement of simple intramedullary nail is 0~2.31 mm,the displacement of double-locking steel plate is 0~0.67 mm,and the displacement of intramedullary nail combined steel wire is 0~2.02 mm.Conclusion Intramedullary nail combined locking steel plate is more moderate in the treatment of femoral shaft fracture stress,and double locking steel plate is the best stable.Intramedullary nail combined locking steel plate can produce more appropriate stress to stimulate the growth of bone scab,and then promote fracture healing.