现代医药卫生
現代醫藥衛生
현대의약위생
Journal of Modern Medicine & Health
2015年
22期
3385-3387
,共3页
股骨%关节成形术,置换%成像,三维%股骨矩重建%骨水泥%股骨粗隆间骨折%老年人
股骨%關節成形術,置換%成像,三維%股骨矩重建%骨水泥%股骨粗隆間骨摺%老年人
고골%관절성형술,치환%성상,삼유%고골구중건%골수니%고골조륭간골절%노년인
Femur%Arthroplasty%replacement%Imaging%three-dimensional%Femur calcar reconstruction%Bone cement%Femoral intertrochanteric fracture%Aged
目的 利用三维有限元技术对高龄患者股骨矩缺损型粗隆间骨折进行建模,分析在髋关节置换中利用骨水泥重建及骨折碎片复位重建股骨矩后的生物力学特性, 并分析2种重建方法的稳定性.方法 建立股骨矩缺损型粗隆间骨折模型(Evans-jeasonⅣ型理想模型),在骨水泥型髋关节置换中分别利用骨水泥重建及股骨矩骨折碎片重建股骨矩,利用三维有限元方法模拟及分析患者双足站立位时,在正常载荷下2种股骨矩重建方法的生物力学稳定性.结果力学加载后,骨水泥重建股骨矩模型最大应力值及最大位移值均较股骨矩骨折复位型小,二者应力值分别为0.635、0.641 MPa,位移值分别为0.028 74、0.028 91 m.分别在2种模型上选取5个相同位点的应力值和位移值作t检验分析,2种模型关节假体的应力值及位移值比较,差异均有统计学意义(P<0.05).结论 2种股骨矩重建方式在假体应力大小、应力分布及假体位移方面有差异,在应力分布均匀性、应力大小及初始微动方面,骨水泥重建型均优于股骨矩骨折复位型.对于股骨矩缺损型粗隆间骨折行骨水泥型髋关节置换时,采用骨水泥直接重建股骨矩生物力学稳定性更好.
目的 利用三維有限元技術對高齡患者股骨矩缺損型粗隆間骨摺進行建模,分析在髖關節置換中利用骨水泥重建及骨摺碎片複位重建股骨矩後的生物力學特性, 併分析2種重建方法的穩定性.方法 建立股骨矩缺損型粗隆間骨摺模型(Evans-jeasonⅣ型理想模型),在骨水泥型髖關節置換中分彆利用骨水泥重建及股骨矩骨摺碎片重建股骨矩,利用三維有限元方法模擬及分析患者雙足站立位時,在正常載荷下2種股骨矩重建方法的生物力學穩定性.結果力學加載後,骨水泥重建股骨矩模型最大應力值及最大位移值均較股骨矩骨摺複位型小,二者應力值分彆為0.635、0.641 MPa,位移值分彆為0.028 74、0.028 91 m.分彆在2種模型上選取5箇相同位點的應力值和位移值作t檢驗分析,2種模型關節假體的應力值及位移值比較,差異均有統計學意義(P<0.05).結論 2種股骨矩重建方式在假體應力大小、應力分佈及假體位移方麵有差異,在應力分佈均勻性、應力大小及初始微動方麵,骨水泥重建型均優于股骨矩骨摺複位型.對于股骨矩缺損型粗隆間骨摺行骨水泥型髖關節置換時,採用骨水泥直接重建股骨矩生物力學穩定性更好.
목적 이용삼유유한원기술대고령환자고골구결손형조륭간골절진행건모,분석재관관절치환중이용골수니중건급골절쇄편복위중건고골구후적생물역학특성, 병분석2충중건방법적은정성.방법 건립고골구결손형조륭간골절모형(Evans-jeasonⅣ형이상모형),재골수니형관관절치환중분별이용골수니중건급고골구골절쇄편중건고골구,이용삼유유한원방법모의급분석환자쌍족참립위시,재정상재하하2충고골구중건방법적생물역학은정성.결과역학가재후,골수니중건고골구모형최대응력치급최대위이치균교고골구골절복위형소,이자응력치분별위0.635、0.641 MPa,위이치분별위0.028 74、0.028 91 m.분별재2충모형상선취5개상동위점적응력치화위이치작t검험분석,2충모형관절가체적응력치급위이치비교,차이균유통계학의의(P<0.05).결론 2충고골구중건방식재가체응력대소、응력분포급가체위이방면유차이,재응력분포균균성、응력대소급초시미동방면,골수니중건형균우우고골구골절복위형.대우고골구결손형조륭간골절행골수니형관관절치환시,채용골수니직접중건고골구생물역학은정성경호.
Objective To conduct the modelling of femoral calcar defected intertrochanteric facture by using the three-dimensional finite element technology,to analyze the biomechanical characteristics of rebuilding femoral calcar by using the bone cement reconstruction and restoration of fracture fragments in hip replacement ,and to analyze the stability of two kinds of recon struction method. Methods The fracture model of femoral calcar defected intertrochanteric facture (Evans-Jeason typeⅣideal model) was established. The femoral calcar was reconstructed by using the bone cement reconstruction and restoration reconstruc-tion of fracture fragments in hip replacement. The three-dimensional finite element method was used to simulate and analyze the biomechanical stability of the two kinds of femoral calcar reconstruction at the feet standing position and under normal load. Re-sults After mechanical loading,compared with the femoral calcar fracture restoration,the maximum stress value and maximum displacement value in the femoral calcar reconstruction model by bone cement were smaller than those in the femoral calcar re-construction model by femoral calcar fracture reduction,the stress values were 0.635,0.641 MPa,the displacement values were 0.028 74,0.028 91 m,respectively. The stress values and displacement values at 5 same points were selected from each model for conducting t test analysis. The stress values and displacement values had statistical differences between these two models of athroplasty(P<0.05). Conclusion Two kinds of femoral calcar reconstruction mode have differences in the aspects of stress intensity , stress distribution and athroplasty displacement,the bone cement reconstruction mode is superior to the femoral calcar fracture reduction mode in the aspects of uniformity of stress distribution ,stress intensity and initial micromotion. Adopting bone cement for directly reconstructing humeral calcar in the bone cement hip replacement of femoral calcar defected intertrochanteric facture has better biomechanical stability.
