中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2015年
5期
433-437
,共5页
髋骨折%六部分%有限元分析%分型
髖骨摺%六部分%有限元分析%分型
관골절%륙부분%유한원분석%분형
Hip fractures%Six segments%Finite element analysis%Classifications
目的 建立股骨近段三维有限元模型,探讨股骨转子间六部分骨折分型的产生机制及临床意义.方法 应用64层螺旋CT对l例60岁正常男性志愿者左股骨近段进行扫描,所得图像以.jPg格式保存,并导入Photoshop 7.0软件进行三维模型绘制,再将所得三维图像运用Super 93软件建立股骨近段三维有限元模型,划分节点764个,单元531个(密质骨306个、松质骨225个).运用该模型模拟人摔倒过程中髋关节内收、外展、内收内旋、外展外旋及髋关节内收内旋同时臀中肌、梨状肌、髂腰肌剧烈收缩状况下股骨转子间的应力分布情况. 结果 单纯髋关节内收时,应力主要分布于外侧骨皮质部并向转子间区扩散(二部分骨折).单纯髋关节外展时,应力主要分布于内侧骨皮质部并向转子间区扩散(二部分骨折).髋关节内收内旋或外展外旋时,应力均在大转子及转子部的前侧壁、后侧壁较为集中,并同时向内、外侧骨皮质及转子间区扩散(三、四部分骨折).髋关节内收内旋同时梨状肌、臀中肌、髂腰肌剧烈收缩时,应力在大转子、小转子及转子部的前侧壁及后侧壁较为集中,并同时向内、外侧骨皮质及转子间区扩散(五、六部分骨折). 结论 股骨转子间六部分骨折分型符合人摔倒时转子部所受的复杂应力情况,结合CT三维重建,较以往的分型更加直观,并可根据不同分型选择手术方式.
目的 建立股骨近段三維有限元模型,探討股骨轉子間六部分骨摺分型的產生機製及臨床意義.方法 應用64層螺鏇CT對l例60歲正常男性誌願者左股骨近段進行掃描,所得圖像以.jPg格式保存,併導入Photoshop 7.0軟件進行三維模型繪製,再將所得三維圖像運用Super 93軟件建立股骨近段三維有限元模型,劃分節點764箇,單元531箇(密質骨306箇、鬆質骨225箇).運用該模型模擬人摔倒過程中髖關節內收、外展、內收內鏇、外展外鏇及髖關節內收內鏇同時臀中肌、梨狀肌、髂腰肌劇烈收縮狀況下股骨轉子間的應力分佈情況. 結果 單純髖關節內收時,應力主要分佈于外側骨皮質部併嚮轉子間區擴散(二部分骨摺).單純髖關節外展時,應力主要分佈于內側骨皮質部併嚮轉子間區擴散(二部分骨摺).髖關節內收內鏇或外展外鏇時,應力均在大轉子及轉子部的前側壁、後側壁較為集中,併同時嚮內、外側骨皮質及轉子間區擴散(三、四部分骨摺).髖關節內收內鏇同時梨狀肌、臀中肌、髂腰肌劇烈收縮時,應力在大轉子、小轉子及轉子部的前側壁及後側壁較為集中,併同時嚮內、外側骨皮質及轉子間區擴散(五、六部分骨摺). 結論 股骨轉子間六部分骨摺分型符閤人摔倒時轉子部所受的複雜應力情況,結閤CT三維重建,較以往的分型更加直觀,併可根據不同分型選擇手術方式.
목적 건립고골근단삼유유한원모형,탐토고골전자간륙부분골절분형적산생궤제급림상의의.방법 응용64층라선CT대l례60세정상남성지원자좌고골근단진행소묘,소득도상이.jPg격식보존,병도입Photoshop 7.0연건진행삼유모형회제,재장소득삼유도상운용Super 93연건건립고골근단삼유유한원모형,화분절점764개,단원531개(밀질골306개、송질골225개).운용해모형모의인솔도과정중관관절내수、외전、내수내선、외전외선급관관절내수내선동시둔중기、리상기、가요기극렬수축상황하고골전자간적응력분포정황. 결과 단순관관절내수시,응력주요분포우외측골피질부병향전자간구확산(이부분골절).단순관관절외전시,응력주요분포우내측골피질부병향전자간구확산(이부분골절).관관절내수내선혹외전외선시,응력균재대전자급전자부적전측벽、후측벽교위집중,병동시향내、외측골피질급전자간구확산(삼、사부분골절).관관절내수내선동시리상기、둔중기、가요기극렬수축시,응력재대전자、소전자급전자부적전측벽급후측벽교위집중,병동시향내、외측골피질급전자간구확산(오、륙부분골절). 결론 고골전자간륙부분골절분형부합인솔도시전자부소수적복잡응력정황,결합CT삼유중건,교이왕적분형경가직관,병가근거불동분형선택수술방식.
Objective To explore the mechanism of six-segment classification of femur intertrochanteric fracture in a three-dimensional finite element model of upper thigh-bone and its clinical relevance.Methods The left upper thigh-bone of a normal male volunteer of 60 years old was scanned using 64-slice CT.After the images were stored in the format of JPG,they were input into photoshop 7.0 for three-dimensional creation.The three-dimensional images were used to make a three-dimensional finite element model of upper thigh-bone using software Super 93.The model consisted of 764 nodes and 531 units (including 306 compact bone units and 225 cancellous bone units).In this model,the stress distribution at the trochanter during human tumbling was analyzed by imitating adduction,abduction,adduction-intemal rotation and abduction-external rotation of the hip,as well as intense muscular contraction of gluteus medius,piriformis and iliopsoas during adduction-internal rotation of the hip.Results Analysis of stress nephogram showed that the stress was distributed mainly at the exterior cortical bone and spread to the inter-trochanteric part in simple hip adduction (two-part fracture) and distributed mainly at the interior cortical bone and spread to the inter-trochanteric part in simple hip abduction (two-part fracture).In adduction-internal rotation or abduction-external rotation of the hip,the stress was focused on the anterior and posterior walls of the greater trochanter and trochanteric part and spread to the exterior and interior cortical bone and the inter-trochanteric part (three-or four-part fracture).During intense muscular contraction of gluteus medius,piriformis and iliopsoas during adduction-internal rotation of the hip,the stress was focused on the anterior and posterior walls of the greater trochanter,lesser trochanter and trochanteric part and spread to the exterior and interior cortical bone and the inter-trochanteric part (five-or six-part fracture).Conclusions The six-segment classification of femur intertrochanteric fracture explains complex stress distributions after human falling.When combined with three-dimensional CT reconstruction,it is more intuitive than other classifications so that it can provide more definite surgical advice for different types of fracture.
