目的:当前的研究试图利用有限元分析来复制不同固定方法的生物力学效果,目的是为治疗PauwelsIII型股骨颈骨折的最佳方式选择建立理论框架。
方法:PauwelsIII型骨折构型,以70°的角度为特征,结合六种不同的内固定方法进行模拟,包括空心压缩螺钉(CCS),动力髋螺钉(DHS),带旋转螺钉(DS)的DHS,带内侧支撑板(MBP)的CCS,股骨近端防旋髓内钉(PFNA),和股骨颈系统(FNS)。这些模型是使用Geomagic和SolidWorks软件开发和完善的。随后,利用Ansys软件进行有限元分析,结合轴向载荷,扭转载荷,产量加载和循环加载。
结果:在轴向载荷条件下,发现内固定和股骨的峰值应力值对于CCS(454.4;215.4MPa)和CCSMBP(797.2;284.2MPa)最高,分别。内固定的相应最大和最小位移记录为CCS为6.65mm,CCSMBP为6.44mm。当承受扭转载荷时,内固定的峰值应力值最高的是CCS+MBP(153.6MPa)和DHS+DS(72.8MPa),而对于股骨,对于CCS+MBP(119.3MPa)和FNS(17.6MPa),观察到最大和最小峰值应力值,分别。此外,内固定的最大和最小位移测量为CCS+MBP为0.249mm,PFNA为0.205mm.此外,所有六种内固定模型在屈服载荷和疲劳寿命方面均表现出优异的性能。
结论:CCS+MBP治疗PauwelsIII型骨折具有最佳的初始机械稳定性。然而,发现MBP更容易受到剪切应力的影响,可能增加板破损的风险。此外,与CCS相比,DHS+DS表现出优越的生物力学稳定性,国土安全部,PFNA,从而为骨折愈合提供更有利的环境。此外,FNS似乎代表了一种有希望的治疗策略,保证在未来的研究中进一步验证。
OBJECTIVE: The current investigation sought to utilize finite element analysis to replicate the biomechanical effects of different fixation methods, with the objective of establishing a theoretical framework for the optimal choice of modalities in managing Pauwels type III femoral neck fractures.
METHODS: The Pauwels type III fracture configuration, characterized by angles of 70°, was simulated in conjunction with six distinct internal fixation methods, including cannulated compression screw (CCS), dynamic hip screw (DHS), DHS with de-rotational screw (DS), CCS with medial buttress plate (MBP), proximal femoral nail anti-rotation (PFNA), and femoral neck system (FNS). These models were developed and refined using Geomagic and SolidWorks software. Subsequently, finite element analysis was conducted utilizing Ansys software, incorporating axial loading, torsional loading, yield loading and cyclic loading.
RESULTS: Under axial loading conditions, the peak stress values for internal fixation and the femur were found to be highest for CCS (454.4; 215.4 MPa) and CCS + MBP (797.2; 284.2 MPa), respectively. The corresponding maximum and minimum displacements for internal fixation were recorded as 6.65 mm for CCS and 6.44 mm for CCS + MBP. When subjected to torsional loading, the peak stress values for internal fixation were highest for CCS + MBP (153.6 MPa) and DHS + DS (72.8 MPa), while for the femur, the maximum and minimum peak stress values were observed for CCS + MBP (119.3 MPa) and FNS (17.6 MPa), respectively. Furthermore, the maximum and minimum displacements for internal fixation were measured as 0.249 mm for CCS + MBP and 0.205 mm for PFNA. Additionally, all six internal fixation models showed excellent performance in terms of yield load and fatigue life.
CONCLUSIONS: CCS + MBP had the best initial mechanical stability in treatment for Pauwels type III fracture. However, the MBP was found to be more susceptible to shear stress, potentially increasing the risk of plate breakage. Furthermore, the DHS + DS exhibited superior biomechanical stability compared to CCS, DHS, and PFNA, thereby offering a more conducive environment for fracture healing. Additionally, it appeared that FNS represented a promising treatment strategy, warranting further validation in future studies.