老年人坐立转换时股骨近端应力分布的有限元分析

目的 通过建立股骨近端有限元模型，分析在坐立（sit-to-stand, STS）转换站立阶段初期，股骨近端在自选速度起立和快速起立条件下的损伤风险。方法 将老年人股骨近端CT影像三维重建、逆向建模完成实体模型。通过材料赋值和网格划分建立有限元模型，基于有限元分析软件ANSYS，通过边界条件约束，并加载1.733、1.837 kN载荷，得到不同起立速度下股骨近端的应力分布和应变。结果 应力集中区域均为大转子内侧边缘和股骨颈。应力和微应变峰值出现在大转子内侧边缘。快速起立下应力峰值为30.16 MPa，微应变峰值为2 553.5；自选速度起立下应力和微应变峰值较低，分别为28.69 MPa和2 430.4。对于股骨颈应力集中区，快速、自选速度起立下应力范围分别为13.42~23.46、12.76~25.51 MPa。结论 频繁的STS转换会使老年人股骨近端有疲劳性骨折的风险；快速STS转换比自选速度STS转换对股骨近端有更高的损伤风险。

Finite Element Analysis on Stress Distributions of Proximal Femur in the Elderly During Sit-to-Stand Transition

Objective By establishing finite element model of the proximal femur, the injury risk of proximal femur under the conditions of self-selected speed rise and rapid rise at initial stage of standing during sit-to-stand (STS) transition was analyzed.Methods CT images of proximal femur in the elderly were processed with three-dimensional (3D) reconstruction and reverse modeling, so as to complete the solid model. The finite element model was established through material assignment and meshing. Based on the finite element analysis software ANSYS, the boundary conditions were constrained, and 1.733 kN and 1.837 kN loads were applied to obtain stress distributions and strain of proximal femur at different rising speeds. Results The stress concentrated at medial edge of the greater trochanter and the femoral neck. The peak stress and micro-strain appeared on inner edge of the larger rotor. The peak stress was 30.16 MPa and peak micro-strain was 2 553.5 at rapid rising speed. The peak stress and peak micro-strain at self-selected rising speed were 28.69 MPa and 2 430.4, respectively, which were relatively lower. For stress concentration area of femoral neck, the stress ranges at rapid rising speed and self-selected rising speed were 13.42-23.46 MPa and 12.76-25.51 MPa, respectively.Conclusions Frequent STS transition may increase the risk of fatigue fractures for proximal femur in the elderly. Rapid STS transition has a higher injury risk for proximal femur than STS transition at self-selected speed.