外展承重支架治疗Perthes病的临床观察和有限元分析

目的总结髋部外展支架治疗Perthes病的效果，分析其生物力学原理。方法用髋外展支架治疗214例、222髋儿童股骨头缺血性坏死，参照廖前德法按优、良、可、差4个等级评价治疗效果。建立股骨上段三维有限元模型，测定髋外展时股骨头内部和股骨颈的应力。结果所有病例经过2年以上的随访，优202髋，良18髋，可2髋。力学分析髋外展时，股骨头内部的应力逐渐缩小；股骨颈的内、外侧方的应力值则逐渐增大。结论用髋部外展支架治疗Perthes病是一种较好的方法，髋外展可改变应力由股骨头经股骨颈的传导。

Treatment of Perthes Disease with Hip Ambulatory Abduction Brace and the Finite Element Analysis

Objective To evaluate the therapeutic effect of hip abudution device on the treatment of Perthes disease and have a biomechanical analysis.Methods Two hundred and fourteen patients (222 hips) were treated with hip ambulatory abudution brace.The therapeutic effect was evaluated according to the mark criterion formulated by Liao Qiande:excellent,better,good,unchanged.A three-dimensional finite element model of femoral head region was reconstructed.The stress on internal femoral head and femoral neck was tested.Results All the patients were followed up for more than 2 years,203 hips were excellent,18 were better and 1 was good.The finite element analysis revealed that with the increased abduction angle of hip,the stress on the internal femoral head decreased,and the stress on femoral neck increased.Conclusion Hip abudution device is good for the treatment of Perthes disease.Hip abduction can change the stress conduction from femoral head to femoral neck.