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不同空心螺钉内固定方式治疗LetenneurⅠ型Hoffa骨折的有限元分析
Finite element analysis of the treatment of Letenneur typeⅠ Hoffa fractures with different cannulated screw fixation methods
投稿时间:2022-03-25  修订日期:2022-06-08
DOI:10.3969/j.issn.1672-5972.2022.06.006
中文关键词:  空心螺钉  Hoffa骨折  有限元
英文关键词:Cannulated screw  Hoffa fractures  Finite element analysis
基金项目:湖北省荆门市科技局引导性项目(2021YDKY002)
作者单位E-mail
陈心敏* 钟祥市人民医院湖北 钟祥431900 cxm0105@163.com 
范文科 钟祥市人民医院湖北 钟祥431900  
陈盼 钟祥市人民医院湖北 钟祥431900  
罗石 钟祥市人民医院湖北 钟祥431900  
熊杰 钟祥市人民医院湖北 钟祥431900  
周勇* 钟祥市人民医院湖北 钟祥431900 zhouyong@163.com 
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中文摘要:
      目的 运用有限元法比较两种不同空心螺钉内固定方式治疗LetenneurⅠ型Hoffa骨折的生物力学差异。方法 基于1名钟祥市人民医院创伤骨科住院患者的股骨CT资料,经过Mimics 19.0和Geomagic studio 2017软件处理后得到仿真右侧股骨三维模型,导入Solidworks 2017软件中与空心钉模型按照标准手术技术装配,通过切割命令模拟LetenneurⅠ型Hoffa骨折,将置钉方向为从前往后定义为A模型,从后往前定义为B模型,A、B模型的股骨、内固定在材料参数、施加载荷、接触摩擦、边界条件等均保持一致,提交运算后在查看股骨应力、内固定应力、骨折端位移和骨折端成角。结果 ①B模型应力(260.6 MPa)远小于A模型整体应力(522.4 MPa),A模型整体出现较明显的应力集中,螺钉尾端均是A、B模型内固定的应力集中处;②A模型骨块位移(0.40 mm)大于B模型位移(0.32 mm),A模型骨折端成角为3.9°,大于B模型的2.6°。结论 单纯空心拉力螺钉治疗LetenneurⅠ型Hoffa骨折,从后往前置钉会具有更好的生物力学效果,更有利于患者的术后康复。
英文摘要:
      Objective To compare biomechanical differences of two different cannulated screw fixation methods in the treatment of Letenneur typeⅠ Hoffa fractures.Methods Based on the femoral CT data of an inpatient in the department of orthopedics of Zhongxiang People's Hospital, the 3D model of simulated right femur was obtained after processing by Mimics 19.0 and Geomagic studio 2017 software, which was imported into Solidworks 2017 software and assembled with the cannulated screw models according to standard surgical techniques. Letenneur typeⅠ Hoffa fractures were simulated by cutting orders, and the screw placement direction from front to back was defined as model A and from back to front as model B. Femur, internal fixation material parameters, applied load, contact friction and boundary conditions of model A and B were kept consistent. After submitting the calculation, femur stress, internal fixation stress, fracture site displacement and angle were checked.Results ①The overall stress of Model A (522.4 MPa) was far greater than that of Model B (260.6 MPa), and Model A showed obvious stress concentration as a whole. The internal fixation of both models bore the maximum stress of the model, which was located at the end of the cannulated screw. ②The fracture site displacement of Model A (0.40 mm) was greater than that of Model B (0.32 mm), and the fracture site angle of Model A was 3.9°, which was greater than that of Model B (2.6°).Conclusion In the treatment of Letenneur typeⅠ Hoffa fractures with cannulated screws, the cannulated screw from back to front has better biomechanical effect and is more conducive to postoperative rehabilitation of patients.
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