股骨颈骨折空心钉内固定手术参数的优化分析

闭合复位空心钉内固定手术是目前治疗股骨颈骨折的常用方法,采用有限元方法对空心钉内固定手术进行力学综合分析,根据股骨近端力学实验的结果,建立股骨近端有限元分析模型,对可能影响手术效果的患者体重、骨折线角度、空心钉布局与角度等几个参数进行分组分析,提取骨折面、钉子的应力应变分析结果,获得了216组不同手术参数组合的情况下,影响术后愈合与承载能力的骨折端面的错位位移、钉孔底部应变、钉子最大应力、股骨最大应变四个参数,并进行综合分析比较,找到一组符合生物力学规律的内固定治疗参数,并应用于医疗机器人手术参数规划及手术效果的评价系统。

The Surgery Parameters Optimizing Analysis of the Internal Fixation of Femoral Neck Fracture

Close reduction and internal fixation with 3 cannulated screws is a widely used method in treating femoral neck fractures. Using the Finite Element Method, optimizing biomechanical parameters were analyzed in this work. According to the results of mechanical experiments and CT scan images, a finite element models of the proximal femur was established. The situations to be analyzed were grouped by patient weight, fracture lines angle, cannulated screw distribution and position. The relative displacement of the fracture site, the strain at the bottom of the screw hole, the max stress of the screw and the max strain of the proximal femur analyzed and the rational parameters of internal fixation of femoral neck fractures were determined. The optimal parameters were found to be consistent the theory of biomechanics.