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不同钉角度的股骨颈动力交叉系统力学分析及临床应用

Mechanical analysis of the femoral neck dynamic intersection system with different nail angles and clinical applications.

作者信息

Wang Ying, Ma Jian-Xiong, Bai Hao-Hao, Lu Bin, Sun Lei, Jin Hong-Zhen, Ma Xin-Long

机构信息

Orthopaedics Institute, Tianjin Hospital, Tianjin University, Tianjin 300050, China.

出版信息

World J Clin Cases. 2023 Jul 16;11(20):4814-4823. doi: 10.12998/wjcc.v11.i20.4814.

Abstract

BACKGROUND

The femoral neck dynamic intersection system (FNS) is mechanically more stable than other internal fixation techniques. Current studies have confirmed that the structural design of FNS has good biomechanical properties in European and American populations. However, whether the suitability of the FNS's 130° main nail angle design for Asian populations has been thoroughly investigated remains unclear.

AIM

To compare the biomechanical stability differences among different main nail angles of the FNS in the treatment of femoral neck fractures in Asian populations.

METHODS

Computed tomography data of the femur of healthy adult male volunteers were imported into Mimics software to create a three-dimensional model of the femur. The model was adapted to the curve using Geomagic software and imported into Solidworks software to construct the Pauwels I femoral neck fracture model and design the FNS internal fixation model using different main nail angles. Afterward, the models were assembled with the FNS fracture model and meshed using the preprocessing Hypermesh software. Subsequently, they were imported into Abaqus software to analyze and evaluate the biomechanical effects of different angles of the FNS main nail on the treatment of femoral neck fractures.

RESULTS

The peak displacement of the proximal femur under different angles of FNS fixation under stress was 7.446 millimeters in the 120° group and 7.416 millimeters in the 125° group; in the 130°, 135°, and 140° FNS fixation groups, the peak displacement was 7.324 millimeters, 8.138 millimeters, and 8.246 millimeters, respectively. In the 120° and 125° FNS fixation groups, the maximum stresses were concentrated at the main nail and the anti-rotation screw, which intersected the fracture line of the femur neck, resulting in peak stresses of 200.7 MPa and 138.8 MPa, respectively. Peak stresses of 208.8 MPa, 219.8 MPa, and 239.3 MPa were observed on the angular locking plate distal to the locking screw in the 130°, 135°, and 140° fixation groups.

CONCLUSION

FNS has significant stress distribution properties, a minimal proximal femoral displacement, and an optimal stability for treating femoral neck fractures in Asian populations when performed with a 130° main nail angle.

摘要

背景

股骨颈动力交叉系统(FNS)在力学上比其他内固定技术更稳定。目前的研究已证实,FNS的结构设计在欧美人群中具有良好的生物力学性能。然而,FNS的130°主钉角度设计对亚洲人群的适用性是否已得到充分研究仍不明确。

目的

比较FNS不同主钉角度在治疗亚洲人群股骨颈骨折时的生物力学稳定性差异。

方法

将健康成年男性志愿者股骨的计算机断层扫描数据导入Mimics软件,创建股骨三维模型。使用Geomagic软件使模型适应曲线,再导入Solidworks软件构建 Pauwels I型股骨颈骨折模型,并设计不同主钉角度的FNS内固定模型。之后,将模型与FNS骨折模型组装,并使用预处理软件Hypermesh进行网格划分。随后,将其导入Abaqus软件,分析和评估FNS主钉不同角度对股骨颈骨折治疗的生物力学影响。

结果

在应力作用下,FNS不同角度固定时股骨近端的峰值位移在120°组为7.446毫米,125°组为7.416毫米;在130°、135°和140°FNS固定组中,峰值位移分别为7.324毫米、8.138毫米和8.246毫米。在120°和125°FNS固定组中,最大应力集中在与股骨颈骨折线相交的主钉和防旋螺钉处,峰值应力分别为200.7兆帕和138.8兆帕。在130°、135°和140°固定组中,在锁定螺钉远端的角形锁定板上观察到的峰值应力分别为208.8兆帕、219.8兆帕和239.3兆帕。

结论

当主钉角度为130°时,FNS在治疗亚洲人群股骨颈骨折时具有显著的应力分布特性、最小的股骨近端位移和最佳的稳定性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a495/10424033/cb6cf963c18b/WJCC-11-4814-g001.jpg

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