摘要
背景:关于老年股骨转子下骨折不同内固定方式的生物力学研究比较多,但关于比较防旋股骨近端髓内钉(Proximal Femoral Nail Antirotation,PFNA)-Ⅱ和亚洲股骨髓内钉固定老年股骨转子下骨折的研究不多。目的:探讨两种髓内钉PFNA-Ⅱ和亚洲股骨髓内钉固定老年股骨转子下骨折的生物力学特点。方法:建立PFNA-Ⅱ和亚洲股骨髓内钉固定股骨转子下骨折的三维有限元模型,三维有限元法分析股骨转子下骨折PFNA-Ⅱ固定和亚洲股骨髓内钉固定的应力分布和位移情况。结果与结论:(1)PFNA-Ⅱ髓内固定系统的整体最大应力、主钉最大应力和髋螺钉或螺旋刀片最大应力值均高于亚洲股骨髓内钉髓内固定系统,PFNA-Ⅱ髓内固定系统的远端锁钉最大应力值和股骨头表面最大应力值低于亚洲股骨髓内钉髓内固定系统;(2)PFNA-Ⅱ髓内固定系统的最大位移主要集中在大转子部和股骨头下极,亚洲股骨髓内钉髓内固定系统的最大位移主要集中在大转子部,PFNA-Ⅱ髓内固定系统的最大位移高于亚洲股骨髓内钉髓内固定系统的最大位移;PFNA-Ⅱ髓内固定系统的最大轴向分位移高于亚洲股骨髓内钉髓内固定系统;PFNA-Ⅱ髓内固定系统的最大矢状面分位移高于亚洲股骨髓内钉髓内固定系统的最大矢状面分位移;PFNA-Ⅱ髓内固定系统的最大冠状面分位移高于亚洲股骨髓内钉髓内固定系统的最大冠状面分位移;(3)PFNA-Ⅱ髓内固定系统的外侧裂隙、前方裂隙和后方裂隙均高于亚洲股骨髓内钉髓内固定系统的外侧裂隙、前方裂隙和后方裂隙,但差别不太明显;(4)PFNA-Ⅱ髓内固定系统的骨折断面最大应力值低于亚洲股骨髓内钉髓内固定系统的的骨折断面最大应力值;(5)结果表明,与PFNA-Ⅱ髓内固定系统相比,亚洲股骨髓内钉固定股骨转子下骨折具有更好的生物力学稳定性。
BACKGROUND： Biomechanical studies on elderly subtrochanteric fracture by different fixation ways were more, but study on relatively proximal femoral nail antirotation-Ⅱ （PFNA） and Asia 2 femur nail （A2FN） fixation for femoral subtrochanteric fractures in the elderly was less. OBJECTIVE： To study the biomechanical analysis of intramedullary nail PFNA-Ⅱ and A2FN fixation for elderly femoral subtrochanteric fractures. METHODS： Three-dimensional finite element models of femoral subtrochanteric fractures fixed by PFNA-Ⅱ and A2FN in the elderly were established. Three-dimensional finite element analysis was used to analyze stress distribution and displacement after femoral subtrochanteric fractures by PFNA-Ⅱ and A2FN fixation. RESULTS AND CONCLUSION： （1） The overall maximum stress, nail maximum stress and hip screw or spiral blade maximum stress values of PFNA-Ⅱ intramedullary fixation system were higher than that of A2FN intramedullary fixation system. The distal locking maximum stress value and femoral head surface maximum stress values of PFNA-Ⅱ intramedullary fixation system were lower than that of A2FN intramedullary fixation system. （2） The maximum displacement of PFNA-Ⅱ intramedullary fixation system was mainly concentrated in the large trochanter and femoral head pole. The maximum displacement of A2FN intramedullary fixation system was mainly concentrated in the large trochanter. The maximum displacement of PFNA-Ⅱ intramedullary fixation system was higher than that of A2FN intramedullary fixation system. The maximum axial displacement of PFNA-Ⅱ intramedullary fixation system was higher than that of A2FN intramedullary fixation system. The maximum sagittal displacement of PFNA-Ⅱ intramedullary fixation system was higher than that of A2FN intramedullary fixation system. The maximum coronal displacement of PFNA-Ⅱ intramedullary fixation system was higher than that of A2FN intramedullary fixation system. （3） The lateral fissure, front fissure and rear fissure of PFNA-Ⅱ intramedullary fixation system were higher than that of A2FN intramedullary fracture fixation system, but the difference was less pronounced. （4） The maximum stress value on fracture section of PFNA-Ⅱ intramedullary fracture fixation system was lower than that of A2FN intramedullary fixation system. （5） Results showed that A2FN intramedullary fixation system for intertrochanteric fractures has better biomechanical stability than PFNA-Ⅱ intramedullary fixation system for intertrochanteric fractures.
出处
《中国组织工程研究》
CAS
北大核心
2016年第31期4644-4650,共7页
Chinese Journal of Tissue Engineering Research
