Shanghai Institute for Minimally Invasive Therapy, University of Shanghai for Science and Technology, Shanghai, China.
Department of Rehabilitation, Shanghai Putuo District People's Hospital, Shanghai, China.
Comput Methods Biomech Biomed Engin. 2022 Feb;25(2):132-139. doi: 10.1080/10255842.2021.1935899. Epub 2021 Jun 7.
In this study, the biomechanical differences among three internal fixation configurations for treatment of Pauwels type II and III femoral neck fractures were analyzed. Using finite element analysis, the femur displacement and stress distributions of the internal fixation device and fracture section were obtained for different patients and movement conditions. The results show that patients with osteoporosis are more prone to femoral varus and femoral neck shortening, and the fracture probability of the device for these patients is higher than that for patients with normal bone. The treatment effect of the inverted-triangle screw (ITS) fixation and proximal femoral nail anti-rotation (PFNA) fixation is better than that of dynamic hip screw (DHS) fixation. The ITS fixation is more suitable for the treatment of the normal bone patients with Pauwels II femur neck fracture. However, the PFNA fixation has better biomechanical advantages and better capability for anti-femoral neck shortening. Therefore, it is suitable for the treatment of femoral neck fracture patients with osteoporosis.
本研究分析了三种内固定方式治疗 Pauwels Ⅱ型和Ⅲ型股骨颈骨折的生物力学差异。通过有限元分析，获得了不同患者和运动状态下内固定装置和骨折部位的股骨位移和应力分布。结果表明，骨质疏松患者更容易发生股骨内翻和股骨颈缩短，且这些患者的内固定装置骨折概率高于正常骨质患者。倒三角钉（ITS）固定和股骨近端防旋髓内钉（PFNA）固定的治疗效果优于动力髋螺钉（DHS）固定。ITS 固定更适合治疗 Pauwels Ⅱ型股骨颈骨折的正常骨质患者。然而，PFNA 固定具有更好的生物力学优势和更好的抗股骨颈缩短能力。因此，它适用于骨质疏松性股骨颈骨折患者的治疗。
