股骨颈骨折愈合后钉道植骨应力分布的有限元分析

目的：探讨股骨颈骨折经空心加压螺钉固定,骨折愈合后取出螺钉遗留的钉道内是否应予植骨,为临床选择治疗方法提供依据。方法：重建人体股骨头颈部的三维有限元仿真模型,模拟钉道不植骨与钉道植骨的股骨头颈部,对模型进行虚拟加载和仿真计算。比较2种模型在同一载荷下的应力分布及位移情况。结果：不植骨模型的最大应力集中在股骨头负重区,植骨模型的最大应力集中在股骨颈下方的内后侧处即股骨矩区,且不植骨模型股骨头负重区应力最大值（0.482 E＋8）远远大于植骨模型应力最大值（0.295 E＋8）;钉道位置的位移测试显示,2组模型股骨头区位移最大,不植骨模型的股骨头区位移值（0.391 E-0.3）明显大于植骨模型的股骨头区位移值（0.352 E-0.3）。结论：股骨颈骨折采用空心加压螺钉内固定,骨折愈合取出螺钉后钉道内植骨有利于提高股骨头颈部的生物力学性能,预防因股骨头部应力过于集中导致的股骨头坏死塌陷。

Finite element analysis of the stress distribution in femoral head and neck of bone grafting in nail path after femoral neck fracture heating

Objective:To investigate the rationality of bone grafting in nail path after femoral neck fracture healing and internal fixator was removed so as to provide theoretical support for clinical therapy.Methods:Two three-dimensional finite element models of the femoral head and neck region were reconstructed after femoral neck fracture healing and internal fixator was removed,one undergone bone grafting.Both of the models were simulated under the load of body weight,and the stress and shift on the femoral head a...